Parent Reports of Mental Health Concerns and Functional Impairment on Routine Screening With the Strengths and Difficulties Questionnaire.
OBJECTIVE
This study used the Strengths and Difficulties Questionnaire (SDQ) to describe the prevalence of parent-reported mental health (MH) concerns in youth presenting for primary care appointments and to examine relationships between children's MH issues and functional impairment. We hypothesized that increased MH symptomology would be associated with increased impairment and family burden.


METHODS
Parents of 4- to 17-year-old children were approached at routine visits in 13 primary care sites. Chi-square tests, independent sample t tests, and a 1-way analysis of variance (ANOVA) were used to make comparisons between demographic groups. Age-, sex-, and race-adjusted ordered logistic regression models and ANOVAs examined relationships between impact and SDQ scales.


RESULTS
Boys had higher total Hyperactivity and Peer Problems. Adolescents showed higher Emotional Symptoms, while younger children showed more Hyperactivity. Latinos reported more Conduct Problems, Hyperactivity, and Peer Problems. Latinos also indicated less distress on the child, impairment at home and school, and family burden. Regression analyses indicated increased odds of impairment with higher scale scores. MH symptoms identified with the SDQ in pediatric primary care settings were associated with parent-reported impairment affecting youth and their families.


CONCLUSIONS
The presence of significant impairment suggests that parents' concerns identified by screening are likely to be clinically important and worthy of practice strategies designed to promote assessment, treatment, and referral for these common problems. Identifying and exploring parents' concerns with strategic use of screening tools may allow primary care providers to directly engage families around the MH issues that affect them most.
Georgetown University Hospital Departments of Psychiatry and Pediatrics, Georgetown University School of Medicine, Washington, DC. Electronic address: mgb33@georgetown.edu.
Matthew G
MG
Biel
Georgetown University Center for Child and Human Development, Washington, DC.
Nicole F
NF
Kahn
Georgetown University Hospital Departments of Psychiatry and Pediatrics, Georgetown University School of Medicine, Washington, DC.
Anjuli
A
Srivastava
MedStar Health Research Institute, Hyattsville, Md.
Mihriye
M
Mete
Georgetown University Hospital Departments of Psychiatry and Pediatrics, Georgetown University School of Medicine, Washington, DC; Georgetown University Center for Child and Human Development, Washington, DC.
My K
MK
Banh
Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Lawrence S
LS
Wissow
Georgetown University Hospital Departments of Psychiatry and Pediatrics, Georgetown University School of Medicine, Washington, DC; Georgetown University Center for Child and Human Development, Washington, DC.
Bruno J
BJ
Anthony
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D010290:Parents / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
impairment; mental health; screening; symptoms; youth