A comparison of psychopathology in child psychiatric inpatients, outpatients, and nonpatients. Implications for treatment planning.

A total of 308 preadolescents who were either psychiatric inpatients, psychiatric outpatients, or nonpatients were studied with semistructured interview research instruments that have been described previously. The three groups of children included 106 children consecutively admitted to a voluntary hospital psychiatric inpatient unit, 101 consecutively admitted children to the same voluntary hospital center psychiatric outpatient clinic, and 101 randomly selected nonpatients. The research instruments included a Spectrum of Suicidal Behavior Scale, a Spectrum of Assaultive Behavior Scale, a Precipitating Events Scale, General Psychopathology (recent and past) Scales, a Family Background Scale, a Child's Concept of Death Scale, an Ego-Functioning Scale, and Ego-Defense Scale, and a Medical-Neurological Assessment Scale. The results of the study indicated that the presence of recent depression and recent and past aggression, the use of such ego defenses as projection, displacement, and regression, and the experience of parental separation were significantly different for the three groups of children. Impulse control and reality testing were best in the nonpatients and poorest in the inpatients. The variables that best predicted the need for psychiatric hospitalization were suicidal behavior, recent depression, recent aggression, poor reality testing, and such ego defenses as projection and regression. Implications of these findings are discussed.