University of Basel, Department of Clinical Child and Adolescent Psychology, Institute of Psychology, 4055 Basel, Switzerland.
Swiss Med Wkly. 2010 Aug 27;140:w13092. doi: 10.4414/smw.2010.13092. eCollection 2010.
Mental disorders emerge in childhood and adolescence and are important risk factors for mental disorders in adolescence and adulthood. Since paediatricians are typically the first to see children with psychological problems, the aim of this study was to obtain a survey of mental disorders of children in paediatric settings.
250 paediatricians completed a questionnaire especially developed for this study, which asked for the estimated frequency and type of mental disorders in their patients, assurance in identifying mental disorders, diagnostic and treatment strategies used for these disorders and requests for training.
Paediatricians estimated that 15% percent of children in their paediatric setting reported psychological difficulties. The most frequent mental disorders indicated by the paediatricians were attention-deficit hyperactivity disorder (ADHD), anxiety disorders, depression and aggressive disorders. Comfort in assigning diagnoses for anxiety disorders and depression was lower than for externalizing disorders. Counselling was the treatment approach most often reported in treating mental disorders, followed by psychopharmacological medication. Psychotherapy, however, was reported very rarely. Paediatricians' wish for continuing education included diagnostics and screening instruments for psychological problems in childhood.
Estimated prevalence rates reported by paediatricians are comparable with rates in epidemiological studies. As paediatricians are often confronted with psychological problems, they have the important role in recognising the early signs of mental problems.
精神障碍在儿童和青少年时期出现，是青少年和成年期精神障碍的重要危险因素。由于儿科医生通常是第一个看到有心理问题的儿童的人，因此本研究的目的是了解儿科环境中儿童的精神障碍情况。
250 名儿科医生完成了一份专门为此研究设计的问卷，询问他们患者中精神障碍的估计频率和类型、识别精神障碍的信心、用于这些障碍的诊断和治疗策略以及培训需求。
儿科医生估计，他们儿科环境中 15%的儿童报告存在心理困难。儿科医生指出的最常见的精神障碍是注意力缺陷多动障碍（ADHD）、焦虑障碍、抑郁和攻击障碍。在为焦虑障碍和抑郁做出诊断时，儿科医生的信心低于为外化障碍做出诊断时的信心。治疗精神障碍最常报告的方法是心理咨询，其次是精神药理学药物治疗。然而，很少有报告称采用了心理治疗。儿科医生继续教育的愿望包括儿童心理问题的诊断和筛查工具。
儿科医生报告的估计患病率与流行病学研究中的患病率相当。由于儿科医生经常面临心理问题，他们在识别精神问题的早期迹象方面发挥着重要作用。
