Overlooked and Underserved: "Action Signs" for Identifying Children With Unmet Mental Health Needs
Overlooked and Underserved: "Action Signs" for Identifying Children With Unmet Mental Health Needs
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DOI：
10.1542/peds.2009-0367
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发表时间：
2011-11-01
期刊：
影响因子：
8
通讯作者：
Roberts, Robert
中科院分区：
文献类型：
--
作者：
Jensen, Peter S.;Goldman, Eliot;Roberts, Robert
目标：美国卫生局局长呼吁采取新的方法，为在过去6到12个月内没有接受评估或服务的大部分有重大心理健康需求的美国儿童填补心理健康服务缺口。作为回应，调查人员试图开发简短、易于理解、科学推导的“警告信号”，以帮助家长、教师和公众更容易地识别有未得到满足的心理健康需求的儿童，并将这些儿童带到卫生保健提供者的注意以进行评估和可能的服务。方法：对来自近6000名儿童和父母的流行病学数据集进行分析，以(1)确定常见但严重损害的症状特征的频率，(2)根据年龄和性别检查症状特征的频率，(3)评估症状特征相对于《精神疾病诊断和统计手册》诊断的阳性预测值，结果：症状谱出现频率在0.5%~2.0%之间，8%的儿童有1个或多个症状谱。档案对损害精神诊断的阳性预测值为中到高(52.7%-75.4%)，但在具有1个或更多档案的儿童中，只有不到25%的儿童在过去6个月内接受过服务。结论：确定了反映严重但基本上未治疗的精神健康问题的科学可靠的症状档案。作为“行动标志”，这些简介可能有助于提高公众对儿童心理健康需求的认识，促进需要评估的特定儿童的沟通和转介，并缩小儿童心理健康服务的差距。儿科2011；128：970-979
OBJECTIVE: The US Surgeon General has called for new approaches to close the mental health services gap for the large proportion of US children with significant mental health needs who have not received evaluation or services within the previous 6 to 12 months. In response, investigators sought to develop brief, easily understood, scientifically derived " warning signs" to help parents, teachers, and the lay public to more easily recognize children with unmet mental health needs and bring these children to health care providers' attention for evaluation and possible services.METHOD: Analyses of epidemiologic data sets from similar to 6000 children and parents were conducted to (1) determine the frequency of common but severely impairing symptom profiles, (2) examine symptom profile frequencies according to age and gender, (3) evaluate positive predictive values of symptom profiles relative to Diagnostic and Statistical Manual of Mental Disorders diagnoses, and (4) examine whether children with 1 or more symptom profiles receive mental health services.RESULTS: Symptom-profile frequencies ranged from 0.5% to 2.0%, and 8% of the children had 1 or more symptom profile. Profiles generated moderate-to-high positive predictive values (52.7%-75.4%) for impairing psychiatric diagnoses, but fewer than 25% of children with 1 or more profiles had received services in the previous 6 months.CONCLUSIONS: Scientifically robust symptom profiles that reflect severe but largely untreated mental health problems were identified. Used as " action signs," these profiles might help increase public awareness about children's mental health needs, facilitate communication and referral for specific children in need of evaluation, and narrow the child mental health services gap. Pediatrics 2011;128:970-979