Brief psychosocial screening at health supervision and acute care visits.
OBJECTIVE
To identify factors associated with positive scores on a brief psychosocial screening tool with subscales for internalizing, externalizing, and attention problems.


METHODS
Parents of 2028 children between the ages of 7 and 15 years seen in a sample of 8 primary care practices in the Minneapolis-St Paul metropolitan area completed a brief questionnaire that included the 17-item Pediatric Symptom Checklist (PSC), demographic information, and the reason for the child's visit to the clinic.


RESULTS
Overall, 22% of the youth had at least 1 positive PSC-17 subscale or a positive PSC-17 total score. Twelve percent scored positive on the internalizing subscale, 10% on the externalizing subscale, 7% on the attention subscale, and 11% had a positive PSC-17 total score. Although boys were more likely than girls to score positive on the attention and aggression subscales, boys and girls were equally likely to have a positive score on the depression subscale. Children not living with both biological parents and those with a household member receiving public assistance were significantly more likely to show psychosocial dysfunction. Controlling for demographic characteristics, patients presenting for an illness-related or injury visit were more likely to score positive on the screen than those presenting for a routine well-child visit (odds ratio: 1.46; 95% confidence interval: 1.07-1.98).


CONCLUSIONS
Clinicians will miss opportunities to identify emotional and behavioral disorders among children and adolescents who may be at a higher risk if they limit psychosocial screening to health supervision visits. Further research is needed to identify effective strategies for using primary care for recognizing, diagnosing, and treating mental health disorders in children and adolescents.
Borowsky
Iris Wagman
IW
Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota 55455, USA. borow004@tc.umn.edu
Mozayeny
Sara
S
Ireland
Marjorie
M
D000208:Acute Disease; D000293:Adolescent; D000374:Aggression; D001288:Attention; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002662:Child Health Services; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008487:Medical History Taking; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008910:Minnesota / Q000453:epidemiology; D009819:Office Visits; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011581:Psychological Tests; D011584:Psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires