Adolescent psychiatric inpatients: Characteristics,outcome, and comparison between discharged patients from a specialized adolescent unit and nonspecialized units

We have recently studied the outcome of school-aged children treated in day hospital and inpatient psychiatric units using four operationally defined preadmission child and parent/family variables as predictors of outcome. Our studies have provided considerable support for these preadmission variables singly and/or in combination in predicting poor outcome in school-aged children in these hospital settings. The present study describes the prevalence of these variables and their ability to predict outcome in two groups of adolescent psychiatric inpatients in the same hospital: one group placed on a specialized adolescent unit and one group placed on other inpatient psychiatric units. The findings indicate that overall there is a lower prevalence of the preadmission variables in the adolescent group compared to the school-aged inpatient group. In the adolescent group, only the preadmission variable of severe aggressive/destructive behavior predicted poor outcome. There appears to be a greater prevalence of severe behavioral disturbance in the group of adolescents discharged from the specialized adolescent unit compared to adolescents discharged from other psychiatric units, and an associated poorer outcome in the former group. Possible reasons for these findings and their implications for the hospital-based evaluation and treatment of aggressive and severely disturbed adolescents are discussed.This paper was presented in part at the 144th annual meeting of the American Psychiatric Association, May 1991.Received M.D. from Albert Einstein College of Medicine. Research interests are outcome of youth treated in psychiatric programs, aggression and conduct disorder, and children of substance-abusing parents.Received M.A. in psychology from the New School for Social Research. Research interests are psychobiology, affective disorders, and metabolic regulation.