title: Perceived parental burden and service use for child and adolescent psychiatric disorders.
abstract: OBJECTIVE
  Pediatric chronic physical illness and adult psychiatric disorders are substantial sources of burden for family care-takers, but little attention has been paid to parental burden resulting from children's or adolescents' psychiatric disorders. This paper describes the predictors of perceived parental burden and its impact on the use of specialty mental health and school services.
  
  
  METHODS
  A representative general population sample of 1015 9-, 11-, and 13-year-olds and their parents completed structured psychiatric diagnostic interviews and the Child and Adolescent Burden Assessment.
  
  
  RESULTS
  Weighted estimates indicated that 10.7% of parents in the general population perceived burden resulting from their children's symptomatology. Significant predictors of perceived burden were levels of child symptomatology and impairment and parental mental health problems. Children's depressive and anxiety disorders were associated with less burden than other diagnoses. The effects of child disorder severity on specialty mental health service use appeared to be mediated by the level of burden induced.
  
  
  CONCLUSIONS
  Substantial levels of parental burden resulted from child psychiatric disorders and were a major reason for specialist mental health service use.
authors.affiliation: Developmental Epidemiology Program, Duke University Medical Center, Durham, NC, USA.
authors.forename: A
authors.initials: A
authors.lastname: Angold
authors.forename: S C
authors.initials: SC
authors.lastname: Messer
authors.forename: D
authors.initials: D
authors.lastname: Stangl
authors.forename: E M
authors.initials: EM
authors.lastname: Farmer
authors.forename: E J
authors.initials: EJ
authors.lastname: Costello
authors.forename: B J
authors.initials: BJ
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000145:classification; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000145:classification; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012494:Sampling Studies; D012720:Severity of Illness Index