title: The Burden of Psychosocial Stressors and Urgent Mental Health Problems in a Pediatric Weight Management Program.
abstract: OBJECTIVE
  To systematically screen for behavioral and mental health problems and psychosocial stressors (PS) in newly referred patients and adult caregivers (PACs) in a pediatric weight management program.
  
  
  METHODS
  We used the Strengths and Difficulties Questionnaire (SDQ), the Center for Epidemiologic Studies Depression Scale (CES-D) for caregivers and patients ≥18 years, and assessed urgent mental health concerns and psychosocial stressors.
  
  
  RESULTS
  A total of 243 PACs were screened; data were unavailable for 6. Compared with US normative data for the SDQ-Parent Proxy Version, the proportion of patients in our sample with borderline/abnormal total difficulties and conduct problems scores was greater for all age groups. Among adult caregivers with complete CES-D, 18.4% were at risk for depression. Eleven percent of patients screened positive for urgent mental health problems. Overall, 43% of patients and 57.4% of caregivers had PS.
  
  
  CONCLUSIONS
  Systematic screening identified untreated symptoms and significant PS. Addressing these complex problems likely requires collaborative approaches with community providers.
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA ian.zenlea@trilliumhealthpartners.ca.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Zenlea
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: E Thomaseo
authors.initials: ET
authors.lastname: Burton
authors.affiliation: Boston Children's Hospital, Boston, MA, USA.
authors.forename: Nissa
authors.initials: N
authors.lastname: Askins
authors.affiliation: Harvard Medical School, Boston, MA, USA Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Emily Israel
authors.initials: EI
authors.lastname: Pluhar
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Erinn T
authors.initials: ET
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D001835:Body Weight; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D010290:Parents / Q000523:psychology; D063766:Pediatric Obesity / Q000150:complications / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: behavioral health; mental health; pediatric obesity; psychosocial stressors; screening