Mental health in pediatric settings: Distribution of disorders and factors related to service use
Mental health in pediatric settings: Distribution of disorders and factors related to service use
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DOI：
10.1097/00004583-200007000-00012
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发表时间：
2000-07-01
影响因子：
13.3
通讯作者：
Leaf, PJ
中科院分区：
文献类型：
--
作者：
Briggs-Gowan, MJ;Horwitz, SM;Leaf, PJ
目标：检查儿科环境中的儿童精神疾病，并确定与父母使用儿科医生作为有关情绪/行为问题和使用心理健康服务的资源相关的因素。方法：样本由儿科诊所代表性样本 (N = 1,060) 中的 5 至 9 岁儿童组成（平均年龄 = 7.17 岁，SD = 1.41）。家长访谈包括使用儿童诊断访谈计划 (DISC-R) 对精神疾病、家长抑郁/焦虑、可能的儿童虐待、压力、支持以及心理健康服务的使用进行评估。结果：任何 DISC 疾病的患病率为 16.8%。父母的抑郁/焦虑和可能的虐待儿童与 2 至 3 倍的疾病发生率独立相关。许多报告有任何疾病的父母（55%）没有报告与儿科医生讨论行为/情感问题。与讨论行为/情感问题相关的因素是是否存在任何疾病和经济压力。与看心理健康专业人士相关的因素包括与儿科医生讨论行为/情感问题、单亲家庭和压力生活事件。结论：这种情况下的疾病患病率表明，儿科医生有能力识别和转诊患有精神疾病的儿童。然而，大多数父母不会与儿科医生讨论行为/情感问题。考虑提高识别率和转诊率的方法（例如常规筛查）。
Objectives: To examine child psychiatric disorders in pediatric settings and identify factors associated with parents' use of pediatricians as resources concerning emotional/behavioral issues and use of mental health services. Method: The sample consists of 5- to 9-year-olds (mean = 7.17 years, SD = 1.41) from a representative sample (N = 1,060) of pediatric practices. Parent interviews included assessments of psychiatric disorders with the Diagnostic Interview Schedule for Children (DISC-R), parental depression/anxiety, possible child abuse, stress, support, and the use of mental health services. Results: The prevalence of any DISC disorder was 16.8%. Parental depression/anxiety and possible child abuse were associated independently with 2- to 3-times higher rates of disorder. Many parents (55%) who reported any disorder did not report discussing behavioral/emotional concerns with their pediatrician. Factors associated with discussing behavioral/emotional issues were the presence of any disorder and financial stress. Factors related to seeing a mental health professional were discussing behavioral/emotional issues with the pediatrician, single parenthood, and stressful life events. Conclusions: The prevalence rates of disorders in this setting suggest that pediatricians are well-placed to identify and refer children with psychiatric disorders. However, most parents do not discuss behavioral/emotional issues with their pediatrician. Methods for improving rates of identification and referral (e.g., routine screening) are considered.