Adolescent Drug Abuse Diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement


Dr Laurent Holzer
Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent
Centre Thérapeutique de Jour pour Adolescents
Av. de Beaumont 48
1012 Lausanne


Background  The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services.

Aims  To compare the ADAD with HoNOSCA; to examine their clinical usefulness.

Methods  Comparison of the ADAD and HoNOSCA outcome measures of 20 adolescents attending a psychiatric day care unit.

Results  ADAD change was positively correlated with HoNOSCA change. HoNOSCA assesses the clinic’s day-care programme more positively than the ADAD. The ADAD detects a group for which the mean score remains unchanged whereas HoNOSCA does not.

Conclusions  A good convergent validity emerges between the two assessment tools. The ADAD allows an evidence-based assessment and generally enables a better subject discrimination than HoNOSCA. HoNOSCA gives a less refined evaluation but is more economic in time and possibly more sensitive to change. Both assessment tools give useful information and enabled the Day-care Unit for Adolescents to rethink the process of care and of outcome, which benefited both the institution and the patients.