Samenvatting

Background: More knowledge about characteristics of children and adolescents who need intensive levels of psychiatric
treatment is important to improve treatment approaches. These characteristics were investigated in those who need
youth Assertive Community Treatment (youth-ACT).
Method: A cross-sectional study among children/adolescents and their parents treated in either a regular outpatient
clinic or a youth-ACT setting in a specialized mental health treatment center in the Netherlands.
Results: Child, parent and family/social context factors were associated with treatment intensification from regular
outpatient care to youth-ACT. The combination of the child, parent, and family/social context factors adds substantially
to the predictive power of the model (Nagelkerke R2 increasing from 36 to 45% for the three domains separately, to
61% when all domains are combined). The strongest predictors are the severity of psychiatric disorders of the child,
parental stress, and domestic violence.
Conclusions: Using a wide variety of variables that are potentially associated with treatment intensification from regular
outpatient clinic to youth-ACT, we constructed a regression model illustrating a relatively strong relation between the
predictor variables and the outcome (Nagelkerke R2 = 0.61), with three strong predictors, i.e. severity of psychiatric
disorders of the child, parental stress, and domestic violence. This emphasizes the importance of a system-oriented
approach with primary attention for problem solving and stress reduction within the system, in addition to
the psychiatric treatment of the child, and possibly also the parents.
Auteurs: Vijverberg, R., Ferdinand, R., Beekman, A., & van Meijel B.