Funding outcome

Mental disorders in children, such as anxiety, depression, and behavioral challenges, are complex, involving both external behaviors and internal feelings like worry and sadness. In child and adolescent mental health services, patient-reported outcome measures (PROMs) collect information about a child's mental health from both the child's and caregiver's perspectives, assessing its impact on quality of life and functioning. However, caregivers and children often perceive symptoms and quality of life differently, leading to consistently low correlations between PROM scores across studies. These discrepancies, known as 'informant discrepancies,' complicate the interpretation of PROM scores in clinical care and research. The source of these discrepancies is not well understood. Some evidence suggests caregivers may overestimate symptoms and underestimate functional abilities, focusing on external behaviors, while children emphasize internal experiences. Discrepancies may also stem from measurement errors or differences in how specific questions are interpreted. This lack of understanding complicates treatment planning and research, potentially leading to care that does not fully address the child's needs. Misinterpreting discrepancies can impact diagnosis, treatment and outcomes, while also threatening research validity. Despite these significant implications, research on informant discrepancies is limited. This study aims to identify patterns in how children and caregivers report mental health challenges and explore the underlying causes of these differences, using PROMs data on anxiety, depression and quality of life from a child and adolescent mental health centre. The objectives are to a) identify factors driving discrepancies and b) provide recommendations for interpreting PROMs in clinical settings. Addressing these discrepancies will support more informed clinical decisions, improving diagnoses, treatments, and outcomes for children with mental health concerns