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Background: This study aims to investigate the relationship between health, anxiety, depression and quality of life of young males with severe emotional and behaviour difficulties in a residential setting. In addition to provide the benchmark from which to monitor the interventions experienced by children and adolescents in Public Care Measures: The following assessment instruments were used in this study; PedsQL, PedsQL `in care' module (QOLIC), SF36, Birleson depression self rating scale, Multidimensional anxiety scale for children (MASC), Health Assessments and case file review. The study was undertakeni n a Scottish residential establishmentw ith threed istinct groups: day, residential and secure care to assess at the time of admission the quality of life, depression, anxiety and health of 196 males, 13-16 years old. These measures were repeated at 12 and 24 weeks. There was a single observation of a control group n= 115 males in 3rd and 4t' year in a mainstream secondary school who were also administered PedsQL, SF36, Birleson and MASC. Results: The PedsQL had a Cronbach alpha greater than 0.7 (except for subscale `emotional functioning' a 0.65,0.6 at 12 and 24 weeks respectively). The SF36 Cronbach alpha was greatert han 0.7 in all domainse xcept for subscales` social functioning' (a < 0.7 at 3 observations), and `vitality' (a < 0.66 and 0.65 at first and second observations). The QOLIC Cronbach alpha was greater than 0.7 in all three observations. There were significant differences between the groups in terms of their quality of life. The 4 results between the groups were found in the PedsQL subscales `physical functioning' where secure > control (p=0.04): secure > residential (p= 0.008); and PedsQL subscale `social functioning' day > control (p=0.026); secure > control (p=0.037). SF36 subscales `role physical secure > residential (p residential (p residential (p=0.001). There were a number of significant differences observed between the groups in the subscales of PedsQL and SF36. MASC did not identify the 3% of young people with a clinical diagnosis of anxiety. The Birleson failed to identify the 2% of the young people who had a clinical diagnosis of depression. The Birleson failed to identify 30% of the young people with current suicidal ideation and 27% of the young people with current suicidal behaviours. On the MASC the control group scored significantly higher on `social anxiety: humiliation and rejection', and `social anxiety: performance fear'. The control and secure group had significantly higher depression scores than the young people in residential and day care. The data on this large sample of participants for this study confirmed these LAAC come from greatly disadvantaged backgrounds and have poor physical, lifestyle and mental health in comparison to their peers. Conclusion: The results revealed were complex and counterintuitive. Although there were no differences between groups using self reported measures in the broad domains of Quality of Life, there were significant differences noted in the subscales of the measurement instruments. This study identified concerns about the sensitivity of both the 5 MASC and Birleson in identifying anxiety and depression in this LAAC population. In addition it has been highlighted that the Birleson did not identify almost one third of the young people who are considered to be most at risk of suicidal ideation and behaviours. 6 |
