Detection of child mental health disorders by general practitioners.

BACKGROUND: Few children with mental disorders access specialist services. Although previous studies suggest that general practitioner (GP) recognition is limited, parents may not be presenting these problems. AIM: To compare GP recognition of disorders with child mental health data and to examine f...

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Published in:British Journal of General Practice Vol. 54; no. 502; pp. 348 - 353
Main Authors: Sayal K, Taylor E
Format: research tables/charts Journal Article
Published: Royal College of General Practitioners 2004 May
Online Access:View this record in EBSCOhost
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      pub: Royal College of General Practitioners
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        atl: Detection of child mental health disorders by general practitioners.
      aug:
        au:
          Sayal K
          Taylor E
        affil: Lecturer, Department of Child Psychiatry, Box PO85, Institute of Psychiatry, Denmark Hill, London SE5 8AF; k.sayal@iop.kcl.ac.uk
      sug:
        subj:
          Mental Disorders Diagnosis
          Parental Attitudes
          Physicians, Family England
          Child
          Child, Preschool
          Data Analysis Software
          England
          Female
          Fisher's Exact Test
          Funding Source
          Logistic Regression
          Male
          Mental Disorders Education
          Odds Ratio
          Parents Education
          Primary Health Care
          Psychological Tests
          Questionnaires
          Sensitivity and Specificity
          Human
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Female
          Male
      ab: BACKGROUND: Few children with mental disorders access specialist services. Although previous studies suggest that general practitioner (GP) recognition is limited, parents may not be presenting these problems. AIM: To compare GP recognition of disorders with child mental health data and to examine factors affecting recognition, in particular whether recognition is enhanced if the parent expresses concern during the consultation. Design of study: A two-phase design involving an initial community survey of children between the ages of 5 and 11 years. In the second phase, primary care attenders who were regarded by their GP as having a mental health disorder were compared with those who were not. SETTING: Five general practices in Croydon, outer London. METHOD: For 186 children attending primary care, GP recognition of disorders was compared with the results of a child mental health questionnaire completed by parents. Accuracy and predictors of GP recognition were examined. RESULTS: Seventy-four per cent of children meeting criteria for caseness were not recognised by GPs as having a mental health disorder. The expression of parental concern in the consultation about a mental health problem increased the sensitivity of recognition from 26% to 88%. Expression of concern also increased GP recognition of non-cases; this reflected GP identification of other mental health and learning problems. Only a third of parents who had concerns expressed these during the consultation. CONCLUSIONS: GPs are responsive to concern and take parental views into account. As well as detecting disorders, GPs are also sensitive to other psychosocial and educational problems that may present in primary care. There is a need for parental education about child mental health disorders.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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