Comfort level of pediatricians and family medicine physicians diagnosing and treating child and adolescent psychiatric disorders.
BACKGROUND
Twelve to twenty-one percent of children and adolescents have psychiatric disorders with at least mild functional impairment. Pediatricians and family medicine physicians prescribe 85% of psychotropic medications taken by children. However, little is known about the comfort level of these physicians with the diagnosis and treatment of psychiatric disorders in children.


OBJECTIVE
To determine the comfort level of physicians in diagnosing and treating psychiatric disorders in children.


METHODS
An anonymous survey was sent to pediatricians and family medicine physicians in upstate New York. Of 483 surveys, 200 surveys were returned.


METHODS
To compare differences between pediatricians and family medicine physicians in comfort in diagnosing and prescribing medications for psychiatric disorders.


RESULTS
After controlling for age, race, and years since residency, pediatricians were more comfortable in diagnosing (O.R. = 3.05, C.I. = 1.40-6.63) and prescribing stimulants for (O.R. = 4.16, C.I. = 1.96-8.84) Attention Deficit Disorder. Family medicine physicians were more comfortable in diagnosing (O.R. = .28, C.I. = .14-.57) and prescribing medication for (O.R. = .44, C.I. = .22-.87) anxiety and depression. Despite the differences in comfort, there were no differences in the percentage of each group prescribing the different medications. Of those who were comfortable in making the diagnoses, 13%-64% were not comfortable in prescribing medications, although they did prescribe.


CONCLUSIONS
Pediatricians and family medicine physicians who prescribe the majority of psychotropic medications for children report disconcerting degrees of discomfort with the diagnosis and treatment of children's psychiatric disorders. The authors discuss the multiple factors that may impact primary care physician's comfort in diagnosing and treating children and adolescents with psychiatric disorders.
Fremont
Wanda P
WP
Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 12310, USA. fremontw@upstate.edu
Nastasi
Robert
R
Newman
Nancy
N
Roizen
Nancy J
NJ
D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D009518:New York; D010372:Pediatrics / Q000193:education; D010821:Physicians, Family / Q000193:education; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*
D011619:Psychotropic Drugs