Screening for childhood anxiety symptoms in primary care: integrating child and parent reports.
OBJECTIVE
Parents' concerns typically determine the focus of a primary care visit. This study examined which information is lost if child reports are excluded from screening for anxiety. It also explores the use in primary care of the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Pediatric Symptom Checklist (PSC-17).


METHODS
Two hundred thirty-six children (8-12 years 11 months) and their parents completed SCARED and PSC-17 before a primary care visit occurring during discrete periods between June 1999 and March 2001.


RESULTS
Child reports yielded higher SCARED scores than parent reports (mean=18.12, SD=12.14 versus 14.43, SD=10.34, p <.001). Somatic/panic and separation anxiety accounted for 73.8% of the excess score from children's reports. The level of parent-reported symptoms did not vary with demographics. Female gender and younger age predicted greater excess reporting by children. Parent and child scores were moderately to highly correlated (R=0.55 total score; 0.40-0.58 subfactors).


CONCLUSIONS
There are discrete anxiety domains in which children's reports are likely to yield more information than that of parents. This phenomenon is almost entirely attributable to variations in the level of symptoms reported by children. Studies are needed to design brief screening procedures that integrate parent and child reports and carry age- and gender-adjusted thresholds.
Wren
Frances J
FJ
Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, CA 94305-5719, USA. fwren@stanford.edu
Bridge
Jeffrey A
JA
Birmaher
Boris
B
D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis*; D002648:Child; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D010287:Parent-Child Relations; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012737:Sex Factors