Detecting emotional and behavioural problems in paediatric clinics.

Area of Science:

• Child Psychology
• Pediatric Health
• Mental Health Services

Background:

• Children with chronic illnesses face higher risks of mental health problems, often manifesting as physical symptoms.
• Prevalence of emotional and behavioral disturbances in children attending general pediatric out-patient clinics requires investigation.
• Assessing the need for psychiatric liaison services within pediatric clinics is crucial.

Purpose of the Study:

• To determine if children in pediatric out-patient clinics have an increased risk of emotional and behavioral disturbances.
• To identify unmet needs for psychiatric liaison services in pediatric settings.
• To evaluate the utility of the Strengths and Difficulties Questionnaire (SDQ) in identifying these issues.

Main Methods:

• A survey of 307 children (aged 5-15) in UK pediatric out-patient clinics.
• Comparison with a national community sample of 10,438 children.
• Parental behavior ratings using the Strengths and Difficulties Questionnaire (SDQ) and clinician ratings of emotional difficulties.

Main Results:

• Children in pediatric clinics were over twice as likely to score in the abnormal range on the SDQ (OR=2.3).
• 20% of children had a probable psychiatric disorder, but only 15 received specialist help.
• Children with brain disorders in neurological clinics had the highest risk (OR=5.8); clinicians identified problems in only a quarter of cases.

Conclusions:

• Increased prevalence of emotional and behavioral disturbances exists in children attending pediatric out-patient clinics.
• The SDQ can aid in routine pediatric assessments for identifying potential psychiatric disorders.
• Improved referral pathways to child mental health services are needed for affected children.