Child anxiety in primary care: Prevalent but untreated
Child anxiety in primary care: Prevalent but untreated
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DOI：
10.1002/da.20039
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发表时间：
2004-01-01
影响因子：
7.4
通讯作者：
Stein, MT
中科院分区：
文献类型：
--
作者：
Chavira, DA;Stein, MB;Stein, MT
我们介绍了大学附属初级保健诊所儿童焦虑症的患病率和治疗利用率。从儿科患者名单中招募家庭，714 个家庭参与了初步研究，其中他们填写了儿童焦虑问卷。根据家长和儿童自我报告问卷 (n = 714)，分别有 22% 和 20% 的儿童在简短的焦虑筛查中超出了建议的临床临界值； 19% 和 14% 的儿童在单独的社交焦虑问卷中超出了临床界限。所有家庭都被邀请参加第二项研究，其中包括儿童-家长版焦虑症访谈时间表以及有关治疗利用的问题；对 190 名家长的电话采访显示，DSM-IV 儿童疾病的 1 年患病率为：特定恐惧症为 10.0% (se = 2.2%)，社交恐惧症为 6.8% (se = 1.8%)，广泛性焦虑症为 3.2% (se = 1.3%)，选择性沉默症为 0.5% (se = 0.7%)，选择性沉默症为 1.6% (se = 1.8%)。重度抑郁症为 0.9%)，心境恶劣为 1.1% (se = 0.7%)，注意力缺陷多动障碍 (ADHD) 为 12.6% (se = 2.4%)。在目前患有焦虑症的儿童中，31% 的人在一生中接受过咨询或药物治疗，而患有抑郁症的儿童和患有多动症的儿童中这一比例为 40% 和 79%。青春期年龄和白人身份是心理治疗使用的预测因素；患有注意力缺陷多动症（ADHD）的诊断是心理治疗和药物使用的预测指标。损害性焦虑症的高患病率以及治疗利用程度极低，表明需要找到方法来识别和传播初级保健机构中针对这些疾病的经经验验证的治疗方法。抑郁与焦虑 20:155-164, 2004。(C) 2005 Wiley-Liss, Inc.
We present prevalence and treatment utilization rates for child anxiety disorders in a university-affiliated primary care clinic. Families were recruited from a pediatric patient list and 714 families participated in an initial study wherein they completed child anxiety questionnaires. According to parent and child self-report questionnaires (n = 714), 22% and 20% of children, respectively, were above a suggested clinical cutoff on a brief anxiety screen; 19% and 14% of children exceeded clinical cutoffs on a separate social anxiety questionnaire. All families were invited to participate in a second study that included the Anxiety Disorders Interview Schedule for Children-Parent Version and questions about treatment utilization; telephone interviews with 190 parents showed 1-year prevalence rates of DSM-IV child disorders to be 10.0% (se = 2.2%) for specific phobia, 6.8% (se = 1.8%) for social phobia, 3.2% (se = 1.3%) for generalized anxiety disorder, 0.5% (se = .7%) for selective mutism, 1.6% (se = .9%) for major depressive disorder, 1.1% (se = .7%) for dysthymia, and 12.6% (se = 2.4%) for attention deficit-hyperactivity disorder (ADHD). Among children with a current anxiety disorder, 31 % had received counseling or medication treatment during their lifetime, compared to 40% of children with depression and 79% with ADHD. Adolescent age and being Caucasian were predictors of psychotherapy use; having an ADHD diagnosis was a predictor of both psychotherapy and medication use. The high prevalence of impairing anxiety disorders, in concert with the very low extent of treatment utilization, suggests a need for methods to identify and disseminate empirically validated treatments for these disorders in the primary care setting. Depression and Anxiety 20:155-164, 2004. (C) 2005 Wiley-Liss, Inc.