Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-25T12:20:34.547Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric disorders in adolescents in primary care

Published online by Cambridge University Press:  03 January 2018

Tami Kramer  and
M. Elena Garralda
Tami Kramer
Affiliation:
Imperial College School of Medicine, St Mary's Campus, Academic Unit of Child and Adolescent Psychiatry, Norfolk Place, London W2 1PG
M. Elena Garralda*
Affiliation:
Imperial College School of Medicine, St Mary's Campus, Academic Unit of Child and Adolescent Psychiatry, Norfolk Place, London W2 1PG
*
Professor M. E. Garralda, Section of Child and Adolescent Psychiatry, Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, St Mary's Campus. Academic Unit of Child and Adolescent Psychiatry, Norfolk Place, London W2 1PG
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Little is known about psychiatric disorders in adolescents who attend primary care.

Method

Prospective study of 13- to 16-year-olds consecutively attending general practice. Information was obtained from adolescents, parents and general practitioners, using questionnaires and research interviews.

Results

136/200 (68%) of adolescent attenders took part. Two per cent presented with psychiatric complaints. From research interviews with adolescents, psychiatric disorder in the previous year was found in 38%, with moderate impairment of functioning in over half (according to Children's Global Assessment Scale scores). Most disorders (42/50, 84%) were emotional (‘internalising’) disorders. Psychiatric disorders were significantly associated with high levels and intensity of physical symptoms and with increased health risks. General practitioner assessment of psychiatric disorders was low on sensitivity (20.8%) but high on specificity (90.7%). Doctors identified most severely affected adolescents.

Conclusions

Depressive and anxiety disorders are common among adolescent general practice attenders and linked to increased physical symptoms; general practitioner recognition is limited.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 6 , December 1998 , pp. 508 - 513
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (1991) Manual for the Child Behaviour Checklist/4–18 and 1991 Profile. Buttlington, VT: University of Vermont Department of Psychiatry.Google Scholar
Ambrosini, P. J., Metz, C., Prabucki, K., et al (1989) Video-tape reliability of the third revised edition of the K–SADS. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 723–728.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Bernstein, G. A., Massie, E. D., Thums, P. D., et al (1997) Somatic symptoms in anxious – depressed school refusers. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 661–668.CrossRefGoogle ScholarPubMed
Bird, H. R., Yager, T. J., Stagezza, B., et al (1990) Impairment in the epidemiological measurement of childhood psychopathology in the community. Journal of the American Academy of Child Adolescent Psychiatry, 29, 796–803.CrossRefGoogle ScholarPubMed
Bowman, F. M. & Garralda, M. E. (1993) Psychiatric morbidity among children who are frequent attenders in general practice. British Journal of General Practice, 43, 6–9.Google ScholarPubMed
Cantwell, D. P., Lewinsohn, P. M., Rhode, P., et al (1997) Correspondence between adolescent report and parent report of psychiatric diagnostic data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 610–619.CrossRefGoogle ScholarPubMed
Chambers, W., Puig-Antich, J., Hirsch, M., et al (1985) The assessment of affective disorders in children and adolescents by semistructured interview. Archives of General Psychiatry, 42, 696–702.CrossRefGoogle ScholarPubMed
Garber, J., Walker, L. & Zeman, J. (1991) Somatization symptoms in a community sample of children and adolescents: further validation of the Children's Somatization Inventory. Journal of Consulting and Clinical Psychology, 3, 588–595.Google Scholar
Garralda, M. E. (1994) Primary care psychiatry. In Child and Adolescent Psychiatry: Modern approaches (eds Rutter, M., Taylor, E. & Hersov, L.), pp. 1055–1070. Oxford: Blackwell Scientific.Google Scholar
Garralda, M. E., Bowman, F. M. & Mandalia, S. (1998) Children with psychiatric disorders who are frequent attenders to primary care. European Child and Adolescent Psychiatry, in press.CrossRefGoogle Scholar
Goldberg, D. (1978) Manual of the General Health Questionnaire. Windsor: NFER – Nelson.Google Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. The Pathway to Psychiatric Care. London: Tavistock.Google Scholar
Leaf, P. J., Alegria, M., Cohen, P., et al (1996) Mental health service use in the community and schools: results from the Four-Community MEGA Study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.CrossRefGoogle Scholar
Lewinsohn, P. M., Gregory, N. C., Seeley, J. R., et al (1994) Major depression in community adolescents: age of onset, episode duration and time to recurrence. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 809–818.CrossRefGoogle ScholarPubMed
Monck, E., Graham, P., Richman, N., et of (1994) Adolescent girls I. Self-reported mood disturbance in a community population. British Journal of Psychiatry, 165, 760–769.CrossRefGoogle Scholar
Read, J. D. (1990) Royal College of General Practitioners Members Reference book. London: RCGP.Google Scholar
Swadi, H. (1992) A longitudinal perspective on adolescent substance abuse. European Child and Adolescent Psychiatry, 1, 156–170.CrossRefGoogle ScholarPubMed
Verhulst, F. C. & Koot, H. M. (eds) (1995) The Epidemiology of Child and Adolescent Psychopathology Oxford: Oxford University Press.Google Scholar
Westman, A. & Garralda, M. E. (1996) Mental health promotion for young adolescents in primary care: a feasibility study. British Journal of General Practice, 46, 317.Google ScholarPubMed
Wood, A., Moore, A., Harrington, R., et al (1996) Clinical validity of major depression – endogenous subtype in adolescent patients. European Child and Adolescent Psychiatry, 5, 155–161.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.