Informative value of referral letters from general practice for child and adolescent mental healthcare.

Although referral letters (RLs) form a nodal point in a patient's care journey, little is known about their informative value in child and adolescent mental healthcare. To determine the informative value of RLs to child and adolescent psychiatry, we conducted a chart review in medical records of min...

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Publicado en:European Child & Adolescent Psychiatry Vol. 32; no. 2; pp. 303 - 316
Autores principales: Aydin, S., Crone, M. R., Siebelink, B. M., Numans, M. E., Vermeiren, R. R. J. M., Westenberg, P. M.
Formato: research tables/charts Journal Article
Publicado: Springer Nature Feb2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2023
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      pub: Springer Nature
      place: New York, New York
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        atl: Informative value of referral letters from general practice for child and adolescent mental healthcare.
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        au:
          Aydin, S.
          Crone, M. R.
          Siebelink, B. M.
          Numans, M. E.
          Vermeiren, R. R. J. M.
          Westenberg, P. M.
        affil: Department of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
      sug:
        subj:
          Mental Health Services In Infancy and Childhood
          Mental Health Services In Adolescence
          Family Practice
          Referral and Consultation
          Writing
          Human
          Male
          Female
          Child, Preschool
          Child
          Adolescence
          Retrospective Design
          Record Review
          Logistic Regression
          Sex Factors
          Age Factors
          Severity of Illness
          Attention Deficit Hyperactivity Disorder
          Anxiety Disorders
          Eating Disorders
          Odds Ratio
          Confidence Intervals
          Descriptive Statistics
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Although referral letters (RLs) form a nodal point in a patient's care journey, little is known about their informative value in child and adolescent mental healthcare. To determine the informative value of RLs to child and adolescent psychiatry, we conducted a chart review in medical records of minors registered at specialized mental healthcare between January 2015 and December 2017 (The Netherlands). Symptoms indicated in RLs originating from general practice (N = 723) were coded and cross-tabulated with the best estimate clinical classifications made in psychiatry. Results revealed that over half of the minors in the sample were classified in concordance with at least one reason for referral. We found fair to excellent discriminative ability for indications made in RLs concerning the most common psychiatric classifications (95% CI AUC: 60.9–70.6 for anxiety disorders to 90.5–100.0 for eating disorders). Logistic regression analyses suggested no statistically significant effects of gender, age, severity or mental healthcare history, with the exception of age and attention deficit hyperactivity disorders (ADHD), as RLs better predicted ADHD with increasing age (OR = 1.14, 95% CI 1.03–1.27). Contextual problems, such as difficulties studying, problems with parents or being bullied were indicated frequently and associated with classifications in various disorder groups. To conclude, general practitioners' RLs showed informative value, contrary to common beliefs. Replication studies are needed to reliably incorporate RLs into the diagnostic work-up.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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