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The purpose of this study was to evaluate the outcome of adolescents with anxiety-based school attendance problems enrolled in a specialist adolescent educational and mental health program that provides educational assistance and social skills development, and to suggest key elements that may account for its apparent effectiveness. Young people attending the Sulman Program in Sydney, Australia, between March 2003 and December 2004 were identified. Baseline information was gathered from the medical records, pre and postintervention personal development questionnaires were given to students, and pre and postratings of function were made. Those attending the program showed improvement in their general level of functioning indicated by completion of a year-long course of study (17 of 24), preparation for employment (17), increased independent travel (5), and self-rated improvement in social skills, stress tolerance and emotional literacy. Pre and poststaff ratings on the Health of the Nation Outcomes Scales Child and Adolescent (HoNOSCA), Children's Global Assessment Scale (CGAS) and Global Assessment of Functioning (GAF) indicated improvement in personal and social functioning. Parental satisfaction was rated as high. The findings confirm the effectiveness of, and need for, flexible programs to support adolescents with social anxiety disorder and other longer-term mental health problems to offset the adverse consequences of early withdrawal from educational and social environments. Several elements may help to explain the program's effectiveness and provide guidance for similar programs elsewhere. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the outcome of adolescents with unipolar, bipolar and psychotic disorders admitted to a specialist child and adolescent mental health service in order to inform and enhance service delivery. Methods: Young people treated over a 2 year period at the Rivendell Unit, Sydney, Australia, were identified. Information was gathered from the medical records, mailed questionnaires and follow-up telephone interviews. Results: Of 114 patients eligible for inclusion in the study, outcome information was available for 85 (75%). After 3 years, there was improvement in mood and general level of functioning for all diagnostic groupings. Overall, suicidal thought, self-harm and suicide attempts were not significantly reduced at follow up and relapse rates were high. Patients with bipolar disorder seemed to have a better response to treatment than other diagnostic groups on general functioning, education and employment. Conclusions: The findings confirm the seriousness and adverse psychosocial consequences of psychotic, unipolar and bipolar mood disorders in this age group, highlighting the need for consistent and systematic follow up of young people after treatment. [ABSTRACT FROM AUTHOR]

There is limited information about the outcome of young people with school refusal. We aimed to describe the functional outcomes of persons with school refusal presenting to a child and adolescent psychiatric unit. Young people assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia, were identified. Information was gathered from the medical records, mailed questionnaires and follow-up telephone interviews. Of 192 patients eligible for inclusion in the study, outcome information was available for 118 (61%); 83 had improved functional outcomes (employment and/or education) at 6 months after treatment and 89 at 3 years after treatment. Dysthymia or comorbid diagnoses were associated with poorer functional outcomes 6 months after treatment/assessment, but not at 3 years. The longer term functional outcomes for those treated for school refusal, apart from those with social phobia or academic difficulties, were favourable. Diagnoses of social phobia and learning difficulties were predictive of poorer functional outcomes 3 years after treatment. Longer or more intensive treatment of those with social phobia may improve outcome. KEYWORDS anxiety disorders; depressive disorders; outcome; school refusal. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of young people presenting with school refusal to a child and adolescent psychiatric unit and examine differences between those admitted for inpatient treatment and the rest. Method: One hundred and ninety-two adolescents who had been assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia were identified. An instrument was developed and used to gather data from files. Diagnoses were made by the consensus of two of the investigators using DSM IV criteria from all sources of information. Results: The commencement of school refusal generally occurred in the first 2 years of high school. School refusers had a high prevalence not only of anxiety, but also of mood and disruptive behaviour disorders. A family history of psychiatric illness was present in over half the sample. There were no differences between those subsequently admitted as inpatients and the rest in terms of symptom scores, family composition, family conflict, family separation or history of abuse. Those admitted for inpatient treatment were more likely to have a diagnosis of mood disorders and comorbid diagnoses and to have a maternal history of psychiatric illness. Conclusions: School refusal in adolescence can be a symptom of a variety of disorders, particularly anxiety and mood disorder. Treatment programs need to be geared to the range of diagnoses which occur in this patient group and to the various circumstances associated with the onset of the problem. [ABSTRACT FROM AUTHOR]

The article offers observations on the naturalistic study done by researchers and medical professionals from the University of Sydney and Northern Sydney Central Coast Area Health Service, Australia to monitor the effect of risperidone in young people. It offers an overview of observations made regarding subject recruitment and administration of the study. The research assistant (RA) had regular phone contacts with the families involved and found that a considerable time and effort were required before all surveys were returned.