Abstract
Objective
This study used the Strengths and Difficulties Questionnaire (SDQ) to describe the
prevalence of parent-reported mental health (MH) concerns in youth presenting for
primary care appointments and to examine relationships between children's MH issues
and functional impairment. We hypothesized that increased MH symptomology would be
associated with increased impairment and family burden.
Methods
Parents of 4- to 17-year-old children were approached at routine visits in 13 primary
care sites. Chi-square tests, independent sample t tests, and a 1-way analysis of variance (ANOVA) were used to make comparisons between
demographic groups. Age-, sex-, and race-adjusted ordered logistic regression models
and ANOVAs examined relationships between impact and SDQ scales.
Results
Boys had higher total Hyperactivity and Peer Problems. Adolescents showed higher Emotional
Symptoms, while younger children showed more Hyperactivity. Latinos reported more
Conduct Problems, Hyperactivity, and Peer Problems. Latinos also indicated less distress
on the child, impairment at home and school, and family burden. Regression analyses
indicated increased odds of impairment with higher scale scores. MH symptoms identified
with the SDQ in pediatric primary care settings were associated with parent-reported
impairment affecting youth and their families.
Conclusions
The presence of significant impairment suggests that parents' concerns identified
by screening are likely to be clinically important and worthy of practice strategies
designed to promote assessment, treatment, and referral for these common problems.
Identifying and exploring parents' concerns with strategic use of screening tools
may allow primary care providers to directly engage families around the MH issues
that affect them most.
Keywords
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References
- Emotional, developmental, and behavioral health of American children and their families: a report from the 2003 National Survey of Children's Health.Pediatrics. 2006; 117: e1202-e1212
- Approaches to recognition and management of childhood psychiatric disorders in pediatric primary care.Pediatr Clin North Am. 1998; 45: 1037-1052
- The continuing shortage of child and adolescent psychiatrists.J Am Acad Child Adolesc Psychiatry. 2006; 45: 1023-1031
American Academy of Pediatrics, Task Force on Mental Health. Strategies for system change in children's mental health: a chapter action kit. Available at: http://www.aap.org/mentalhealth/mh2ch.html. Accessed June 14, 2013.
- The future of pediatrics: mental health competencies for pediatric primary care.Pediatrics. 2009; 124: 410-421
- Behavioral assessment of children and adolescents.Pediatr Clin North Am. 1992; 39: 369-378
- Detection of behavioral, developmental, and psychosocial problems in pediatric primary care practice.Curr Opin Pediatr. 1993; 5: 531-536
- Early detection of developmental and behavioral problems.Pediatr Rev. 2000; 21: 272-280
- Utility of the pediatric symptom checklist for behavioral screening of disadvantaged children.Child Psychiatry Hum Dev. 2001; 31: 269-278
- Increases in behavioral health screening in pediatric care for Massachusetts Medicaid patients.Arch Pediatr Adolesc Med. 2011; 165: 660-664
- Mental health screening in pediatric practice: factors related to positive screens and the contribution of parental/personal concern.Pediatrics. 2006; 118: 1896-1906
- The role of parental burden on service use: longitudinal study.J Am Acad Child Adolesc Psychiatry. 2004; 43: 1328-1333
- Universal mental health screening in pediatric primary care: a systematic review.J Am Acad Child Adolesc Psychiatry. 2013; 52: 1134-1147.e23
- The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden.J Child Psychol Psychiatry. 1999; 40: 791-799
- Perceived parental burden and service use for child and adolescent psychiatric disorders.Am J Public Health. 1998; 88: 75-80
- Use of the extended Strengths and Difficulties Questionnaire (SDQ) to predict psychiatric caseness in Hong Kong.Child Psychiatry Hum Dev. 2014; 45: 703-711
- US children with emotional and behavioral difficulties: data from the 2001, 2002, and 2003 National Health Interview Surveys.Adv Data. 2005; : 1-13
- The Strengths and Difficulties Questionnaire: US normative data and psychometric properties.J Am Acad Child Adolesc Psychiatry. 2005; 44: 557-564
- Psychometric properties of the Strengths and Difficulties Questionnaire.J Am Acad Child Adolesc Psychiatry. 2001; 40: 1337-1345
- Parent and teacher mental health ratings of children using primary care services: inter-rater agreement and implications for mental health screening.Ambul Pediatr. 2006; 6: 347
- Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka.Eur Child Adolesc Psychiatry. 2000; 9: 129-134
- The Strengths and Difficulties Questionnaire (SDQ) as a screening measure prior to admission to a child and adolescent mental health service (CAMHS).Aust e-J Adv Mental Health. 2002; 1: 235-246
- Above and below the threshold: severity of psychiatric symptoms and functional impairment in a pediatric sample.Pediatrics. 1992; 90: 359-368
- Strengths and Difficulties Questionnaire as a dimensional measure of child mental health.J Am Acad Child Adolesc Psychiatry. 2012; 48: 400-403
- Identification of youth psychosocial problems during pediatric primary care visits.Adm Policy Ment Health. 2007; 34: 269-281
- Which physicians are providing health care to America's children? Trends and changes during the past 20 years.Arch Pediatr Adolesc Med. 2004; 158: 22
- National ambulatory medical care survey: 2002 summary.Adv Data. 2004; : 1-44
- The Strengths and Difficulties Questionnaire: a research note.Child Psychol Psychiat. 1997; 38: 581-586
- Prevalence and correlates of ADHD symptoms in the national health interview survey.J Atten Disord. 2005; 9: 392-401
- Mood disorders in children and adolescents: an epidemiologic perspective.Biol Psychiatry. 2001; 49: 1002-1014
- Normative data and scale properties of the German Parent SDQ.Eur Child Adolesc Psychiatry. 2004; 13: ii3-ii10
- Racial and ethnic disparities in pediatric mental health.Child Adolesc Psychiatr Clin N Am. 2010; 19: 759-774
- Depression and anxiety among first-generation immigrant Latino youth: key correlates and implications for future research.J Nerv Ment Dis. 2010; 198: 470
- 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology.J Am Acad Child Adolesc Psychiatry. 2006; 45: 8-25
- Impact of children's mental health problems on families relationships with service use.J Emot Behav Disord. 1997; 5: 230-238
- Improving access to mental health care for children: the Massachusetts Child Psychiatry Access Project.Pediatrics. 2010; 126: 1191-1200
- Early Childhood Mental Health Consultation.US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, Rockville, Md2005
- A common factors approach to improving the mental health capacity of pediatric primary care.Adm Policy Ment Health. 2008; 35: 305-318
- Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial.Arch Gen Psychiatry. 2012; 69: 274-282
Article Info
Publication History
Published online: April 25, 2015
Accepted:
January 17,
2015
Received:
June 2,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
