Brief psychosocial screening at health supervision and acute care visits
Brief psychosocial screening at health supervision and acute care visits
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DOI：
10.1542/peds.112.1.129
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发表时间：
2003-07-01
期刊：
影响因子：
8
通讯作者：
Ireland, M
中科院分区：
文献类型：
--
作者：
Borowsky, IW;Mozayeny, S;Ireland, M
目标。目的：在一个简明的心理社会筛查工具上找出与积极分数相关的因素，该工具带有内在性、外在性和注意力问题的子量表。在明尼阿波利斯-圣保罗大都会地区的8个初级保健机构中，2028名7至15岁儿童的父母完成了一份简短的问卷，其中包括17个项目的儿科症状检查表(PSC)、人口统计信息以及儿童就诊的原因。总体而言，22%的青年至少有1个PSC-17分量表或PSC-17总分阳性。12%的人在内化分量表上得分为阳性，10%的人在外化分量表上得分为正，7%的人在注意力分量表上得分为正，11%的人PSC-17总分为正。虽然男孩比女孩更有可能在注意力和攻击性分量表上获得积极的分数，但男孩和女孩在抑郁分量表上获得积极分数的可能性是一样的。没有与亲生父母一起生活的儿童和那些有一名家庭成员接受公共援助的儿童更有可能出现心理社会功能障碍。控制人口统计学特征，因疾病或受伤就诊的患者比常规就诊的健康儿童患者更有可能在屏幕上获得阳性分数(优势比：1.46；95%可信区间：1.07-1.98)。临床医生将错过在儿童和青少年中识别情绪和行为障碍的机会，如果他们将心理社会筛查限制在健康监督访问中，他们可能处于更高的风险中。需要进一步的研究来确定利用初级保健来识别、诊断和治疗儿童和青少年心理健康障碍的有效策略。
Objective. To identify factors associated with positive scores on a brief psychosocial screening tool with subscales for internalizing, externalizing, and attention problems.Methods. Parents of 2028 children between the ages of 7 and 15 years seen in a sample of 8 primary care practices in the Minneapolis-St Paul metropolitan area completed a brief questionnaire that included the 17-item Pediatric Symptom Checklist (PSC), demographic information, and the reason for the child's visit to the clinic.Results. Overall, 22% of the youth had at least 1 positive PSC-17 subscale or a positive PSC-17 total score. Twelve percent scored positive on the internalizing subscale, 10% on the externalizing subscale, 7% on the attention subscale, and 11% had a positive PSC-17 total score. Although boys were more likely than girls to score positive on the attention and aggression subscales, boys and girls were equally likely to have a positive score on the depression subscale. Children not living with both biological parents and those with a household member receiving public assistance were significantly more likely to show psychosocial dysfunction. Controlling for demographic characteristics, patients presenting for an illness-related or injury visit were more likely to score positive on the screen than those presenting for a routine well-child visit (odds ratio: 1.46; 95% confidence interval: 1.07-1.98).Conclusions. Clinicians will miss opportunities to identify emotional and behavioral disorders among children and adolescents who may be at a higher risk if they limit psychosocial screening to health supervision visits. Further research is needed to identify effective strategies for using primary care for recognizing, diagnosing, and treating mental health disorders in children and adolescents.