title: Mental health in pediatric settings: distribution of disorders and factors related to service use.
abstract: OBJECTIVE
  To examine child psychiatric disorders in pediatric settings and identify factors associated with parents' use of pediatricians as resources concerning emotional/behavioral issues and use of mental health services.
  
  
  METHODS
  The sample consists of 5- to 9-year-olds (mean = 7.17 years, SD = 1.41) from a representative sample (N = 1,060) of pediatric practices. Parent interviews included assessments of psychiatric disorders with the Diagnostic Interview Schedule for Children (DISC-R), parental depression/anxiety, possible child abuse, stress, support, and the use of mental health services.
  
  
  RESULTS
  The prevalence of any DISC disorder was 16.8%. Parental depression/anxiety and possible child abuse were associated independently with 2- to 3-times higher rates of disorder. Many parents (55%) who reported any disorder did not report discussing behavioral/emotional concerns with their pediatrician. Factors associated with discussing behavioral/emotional issues were the presence of any disorder and financial stress. Factors related to seeing a mental health professional were discussing behavioral/emotional issues with the pediatrician, single parenthood, and stressful life events.
  
  
  CONCLUSIONS
  The prevalence rates of disorders in this setting suggest that pediatricians are well-placed to identify and refer children with psychiatric disorders. However, most parents do not discuss behavioral/emotional issues with their pediatrician. Methods for improving rates of identification and referral (e.g., routine screening) are considered.
authors.affiliation: Yale University Department of Psychology, New Haven, CT 06520, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Briggs-Gowan
authors.forename: S M
authors.initials: SM
authors.lastname: Horwitz
authors.forename: M E
authors.initials: ME
authors.lastname: Schwab-Stone
authors.forename: J M
authors.initials: JM
authors.lastname: Leventhal
authors.forename: P J
authors.initials: PJ
authors.lastname: Leaf
mesh_terms: D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003237:Connecticut / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health; D010290:Parents / Q000523:psychology*; D010372:Pediatrics / Q000706:statistics & numerical data*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D012307:Risk Factors; D012494:Sampling Studies; D012959:Socioeconomic Factors