An Audit of 7000 Successive Child and Adolescent Psychiatry Referrals in Scotland

Abstract

Approximately 7000 consecutive new referrals were included in a medical audit project of child and adolescent psychiatric outpatient services throughout Scotland over a one-year period. The non-attendance rate was 28 percent, so that comprehensive data were obtained on approximately 5000 cases. The average age at referral was 10.6 years with boys forming 56 percent of referrals. Conduct and mixed disorders accounted for 37 percent of the diagnostic categories with the small number of patients with hyperkinetic disorder rated as most disturbed. Four treatments (parental counselling, consultation, behavioural, family therapy), often in conjunction, were most commonly used with improvement occurring in 70 percent of children. The project improved the cohesion and professional identity of consultant child and adolescent psychiatrists working in Scotland; standards of data collection and diagnostic practice were raised; and the project generated a database for use in substantive research projects.