(PS6-B35) Health-related Quality of Life Among Children Presenting for Intensive Psychiatric Services

Objective. Assessing children’s health-related quality of life (HRQoL) has important implications for treatment of children in high-acuity clinical settings. However, research examining HRQoL among children in psychiatric settings is scarce and has occurred primarily in outpatient settings, limiting our understanding of children’s HRQoL in more acute settings. Thus, the purpose of this study is to describe the HRQoL of children in a partial hospitalization program (PHP), examine selected correlates of HRQoL, and explore the associations between HRQoL and other measures of psychosocial functioning.

Method. The study included a total of 301 children (7–12-years-old) with severe psychopathology who presented for intensive hospital-based treatment. Children and caregivers completed the Pediatric Quality of Life Inventory Version 4.0 (PedsQL) at admission. Caregivers also completed the Family Impact Module of the PedsQL. Confirmatory factor analysis (CFA) was used to evaluate factor structure, followed by additional psychometric analyses to support reliability, validity, and sensitivity to treatment-related change.

Results. CFA results of the parent report version suggest poor model fit based on the original factor structure, CFI = 747, SRMR = .1112, RMSEA = .10. A refined model was tested, dropping items with poor psychometric properties for a 13-item version that had good model fit, CFI = 967, SRMR = .052, RMSEA = .056. A similar model misfit was found in the youth report, with the 13-item model demonstrating good model fit. Cross-informant consistency was low to moderate ranging from r = .20 to .34. A large proportion of children were within the at-risk or impaired range based on parent (77.6%) and youth reports (66.8%). Across informants, PedsQL total scores were related to internalizing (e.g., anxiety, depression, SI) and externalizing (e.g., defiance, hyperactivity-impulsivity) problems, transdiagnostic factors (e.g., irritability, sleep disturbance), and family functioning (e.g., positive parenting practices). Finally, PedsQL scores significantly improved with intensive intervention, p < .05, d = .27, with 74.4% of children reporting clinically significant improvement in HRQoL.

Conclusion. Findings from this study reveal that children seeking intensive intervention services experience significantly impaired HRQoL. Refinements to factor structure resulted in improved psychometric properties of both caregiver and youth reported on the PedsQL. Low cross-informant consistency for children in intensive treatment suggests the importance of collecting multiple perspectives in HRQoL assessment. Finally, children receiving intensive intervention services reported a significant improvement in HRQoL.