European Child & Adolescent Psychiatry

, Volume 14, Issue 7, pp 364–370 | Cite as

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

  • Dennis Bastiaansen
  • Hans M. Koot
  • Robert F. Ferdinand



The aim of this study was to assess the association between change in psychopathology and Quality of Life (QoL) across time in children with high levels of psychopathology.


A referred sample of 126 seven- to 19-year-olds was studied across a 1-year follow-up period. Information concerning QoL and psychopathology was obtained from parents.


Overall, 38.1% of children showed neither psychiatric symptom reduction nor QoL improvement, 33.3% of children showed both a clinically significant psychiatric symptom reduction and QoL improvement, and 28.6% of children showed either psychiatric symptom reduction or QoL improvement. In 11.1% of all children,QoL improved, while the level of psychopathology remained high. Age, gender, or psychiatric diagnosis did not predict a poor outcome of persistently high psychopathology scores and poor QoL.


QoL in children with psychiatric problems may be improved by reducing psychiatric symptoms in a number of children, but it is also possible to improve QoL without psychiatric symptom reduction. This implicates that QoL should become an important aim and treatment outcome measure of psychiatric treatment programs, especially since psychopathology tends to persist.

Key words

Quality of Life child psychiatric disorder follow-up 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Achenbach TM (1991) Manual for the Child Behavior Checklist/4–18 and 1991 Profiles. University of Vermont, Department of Psychiatry, BurlingtonGoogle Scholar
  2. 2.
    Barrett PM, Duffy AL,Dadds MR, Rapee RM (2001) Cognitive-behavioral treatment of anxiety disorders in children: Long-term (6-year) follow-up. J Consult Clin Psychol 69:135–141CrossRefPubMedGoogle Scholar
  3. 3.
    Bastiaansen D, Koot HM, Bongers IL, Varni JW,Verhulst FC (2004) Measuring quality of life in children referred for psychiatric problems: Psychometric properties of the PedsQL™ 4.0 generic core scales. Qual Life Res 13:489–495CrossRefPubMedGoogle Scholar
  4. 4.
    Bastiaansen D, Koot HM, Ferdinand RF (2005) Determinants of quality of life in children with psychiatric disorders. Qual Life Res 14:1599–1612CrossRefPubMedGoogle Scholar
  5. 5.
    Bastiaansen D, Koot HM, Ferdinand RF, Verhulst FC (2004) Quality of life in children with psychiatric disorders: self-, parent, and clinician report. J Am Acad Child Adolesc Psychiatry 43:221–230CrossRefPubMedGoogle Scholar
  6. 6.
    Biederman J, Faraone SV, Taylor A, Sienna M, Williamson S, Fine C (1998) Diagnostic continuity between child and adolescent ADHD: Findings from a longitudinal clinical sample. J Am Acad Child Adolesc Psychiatry 37:305–313CrossRefPubMedGoogle Scholar
  7. 7.
    Browne S, Roe M, Lane A, Gervin M, Morris M, Kinsella A, Larkin C, O’Callaghan E (1996) A preliminary report on the effect of a psychosocial and educative rehabilitation programme on quality of life and symptomatology in schizophrenia. Eur Psychiatry 11:386–389CrossRefGoogle Scholar
  8. 8.
    Cohen J (1988) Statistical power analysis for the behavioral sciences 2nd ed. Erlbaum, Hillsdale, NJGoogle Scholar
  9. 9.
    Dutch Central Bureau of Statistics (1993) Standaard Beroepenclassificatie 1992 (Standardized Classification of Occupations 1992). In: Netherlands Central Bureau of Statistics, Voorburg/HeerlenGoogle Scholar
  10. 10.
    Eiser C, Morse R (2001) Can parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 10:347–357CrossRefPubMedGoogle Scholar
  11. 11.
    Heijmens Visser J, Van Der Ende J, Koot HM, Verhulst FC (2003) Predicting change in psychopathology in youth referred to mental health services in childhood or adolescence. J Child Psychol Psychiatry 44:509–519CrossRefPubMedGoogle Scholar
  12. 12.
    Hofstra MB, Van der Ende J, Verhulst FC (2000) Continuity and change of psychopathology from childhood into adulthood: A 14-year follow-up study. J Am Acad Child Adolesc Psychiatry 39:850–858CrossRefPubMedGoogle Scholar
  13. 13.
    Hudziak JJ, Helzer JE, Wetzel MW, Kessel KB, Mc Gee B, Janca A, Przybeck T (1993) The use of the DSM-III–R Checklist for initial diagnostic assessments. Compr Psychiatry 34:375–383CrossRefPubMedGoogle Scholar
  14. 14.
    Jacobson NS, Follette WC, Revenstorf D (1984) Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy 15:336–352Google Scholar
  15. 15.
    Jacobson NS, Roberts LJ, Berns SB, McGlinchey JB (1999) Methods for defining and determining the clinical significance of treatment effects: Description, application, and alternatives. J Consult Clin Psychol 67:300–307CrossRefPubMedGoogle Scholar
  16. 16.
    Jacobson NS, Truax P (1991) Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 59:12–19CrossRefPubMedGoogle Scholar
  17. 17.
    Landgraf JM, Abetz L, Ware JE (1996) The CHQ User’s Manual. The Health Institute, New England Center, Boston MTAGoogle Scholar
  18. 18.
    Cooperative Group (1999) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 56:1073–1086CrossRefPubMedGoogle Scholar
  19. 19.
    Pine DS, Cohen P, Gurley D, Brook JS, Ma Y (1998) The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry 55:56–64CrossRefPubMedGoogle Scholar
  20. 20.
    Rao U, Ryan ND, Birmaher B, Dahl RE, Williamson DE, Kaufman J, Rao R, Nelson B (1995) Unipolar depression in adolescents: Clinical outcome in adulthood. J Am Acad Child Adolesc Psychiatry 34:566–578CrossRefPubMedGoogle Scholar
  21. 21.
    Sawyer MG, Whaites L, Rey JM, Hazell PL, Graetz BW, Baghurst P (2002) Health-related quality of life of children and adolescents with mental disorders. J Am Acad Child Adolesc Psychiatry 41:530–537CrossRefPubMedGoogle Scholar
  22. 22.
    Schmeck K, Poustka F (1997) Quality of life and child psychiatric disorders. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of Life in Mental Disorders. Wiley, Chichester, pp 179–191Google Scholar
  23. 23.
    Speer DC (1992) Clinically significant change: Jacobson and Truax (1991) revisited. J Consult Clin Psychol 60:402–408CrossRefPubMedGoogle Scholar
  24. 24.
    Spence SH, Sheffield JK, Donovan CL (2003) Preventing adolescent depression: An evaluation of the Problem Solving For Life program. J Consult Clin Psychol 71:3–13PubMedGoogle Scholar
  25. 25.
    Stanger C, MacDonald VV, McConaughy SH, Achenbach TM (1996) Predictors of cross-informant syndromes among children and youths referred for mental health services. J Abnorm Child Psychol 24:597–614CrossRefPubMedGoogle Scholar
  26. 26.
    Tenney NH, Denys DAJP, van Megen HJGM, Glas G, Westenberg HGM (2003) Effect of a pharmacological intervention on quality of life in patients with obsessive-compulsive disorder. Int Clin Psychopharmacol 18:29–33CrossRefPubMedGoogle Scholar
  27. 27.
    Varni JW, Seid M, Kurtin PS (2001) PedsQL 4.0™: Reliability and validity of the Pediatric Quality of Life Inventory™ version 4.0 Generic Core Scales in healthy and patient populations. Med Care 39:800–812CrossRefPubMedGoogle Scholar
  28. 28.
    Verhulst FC, Van der Ende J, Koot HM (1996) Manual for the CBCL/4–18. Department of Child and Adolescent Psychiatry, Sophia Children’s Hospital/Erasmus University, RotterdamGoogle Scholar
  29. 29.
    Vostanis P, Feehan C, Grattan E (1998) Two-year outcome of children treated for depression. Eur Child Adolesc Psychiatry 7:12–18CrossRefPubMedGoogle Scholar
  30. 30.
    Wallander JL, Schmitt M, Koot HM (2001) Quality of life measurement in children and adolescents: Issues, instruments and applications. J Clin Psychol 57:571–585CrossRefPubMedGoogle Scholar
  31. 31.
    Weiss B, Harris V, Catron T, Han SS (2003) Efficacy of the RECAP intervention program for children with concurrent internalizing and externalizing problems. J Consult Clin Psychol 71:364–374CrossRefPubMedGoogle Scholar
  32. 32.
    Wilson SJ, Lipsey MW, Derzon JH (2003) The effects of school-based intervention programs on aggressive behavior: A meta-analysis. J Consult Clin Psychol 71:136–149PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • Dennis Bastiaansen
    • 1
  • Hans M. Koot
    • 1
    • 2
  • Robert F. Ferdinand
    • 1
  1. 1.Erasmus-MC—University Medical Center Rotterdam, Sophia Children’s Hospital, Department of Child and Adolescent PsychiatryCB RotterdamThe Netherlands
  2. 2.Vrije Universiteit Amsterdam, Department of Developmental PsychologyBT AmsterdamThe Netherlands

Personalised recommendations