| Primary care clinicians' use of standardized psychiatric diagnoses. | |
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MedLine Citation:
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PMID: 15320918 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Treatment of child mental health (MH) problems should be informed by psychiatric diagnosis. Whether primary care clinicians (PCCs) use standardized psychiatric diagnostic criteria to direct the treatment of child MH problems is unknown. This study investigated PCCs' use of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria during office visits. METHODS: The data were obtained from 3674 children ages 4-15 years who were recognized as having one or more MH problems during office visits by clinicians participating in the Child Behaviour Study. Parents completed questionnaires before seeing the clinician. Clinicians completed a survey after the visit. The primary outcome was whether PCCs used standardized criteria to generate a diagnosis for children with recognized MH problems. RESULTS: Clinicians used DSM criteria in 23% of visits in which a psychosocial problem was recognized, and 57% of PCCs reported no use of DSM. DSM criteria were used most frequently (38% of visits) when PCCs reported attention problems. Medications were much more likely to be prescribed during visits when PCCs diagnosed using DSM criteria (63% of visits vs. 19% when criteria were not used). However, only 51% of psychotropic medication prescriptions were based on a DSM diagnosis. CONCLUSIONS: Clinicians used standardized criteria infrequently, and primarily to diagnose attention problems. |
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Authors:
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W Gardner; K J Kelleher; K A Pajer; J V Campo |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Child: care, health and development Volume: 30 ISSN: 0305-1862 ISO Abbreviation: Child Care Health Dev Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-23 Completed Date: 2005-02-03 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7602632 Medline TA: Child Care Health Dev Country: England |
Other Details:
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Languages: eng Pagination: 401-12 Citation Subset: IM |
Affiliation:
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Department of Pediatrics and the Children's Research Institute, The Ohio State University, Ohio 43205, USA. GardnerW@pediatrics.ohio-state.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Attention Deficit Disorder with Hyperactivity / diagnosis Attitude of Health Personnel Child Child Behavior Disorders / diagnosis Child, Preschool Counseling Diagnostic and Statistical Manual of Mental Disorders* Female Humans Male Mental Disorders / diagnosis*, drug therapy Primary Health Care / methods* Psychiatric Status Rating Scales* Questionnaires Referral and Consultation Severity of Illness Index |
| Grant Support | |
ID/Acronym/Agency:
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MCJ-177022//PHS HHS; MH50629/MH/NIMH NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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