Pediatrics. 2015 Feb;135(2):384-95. doi: 10.1542/peds.2014-3716.
By current estimates, at any given time, approximately 11% to 20% of children in the United States have a behavioral or emotional disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Between 37% and 39% of children will have a behavioral or emotional disorder diagnosed by 16 years of age, regardless of geographic location in the United States. Behavioral and emotional problems and concerns in children and adolescents are not being reliably identified or treated in the US health system. This clinical report focuses on the need to increase behavioral screening and offers potential changes in practice and the health system, as well as the research needed to accomplish this. This report also (1) reviews the prevalence of behavioral and emotional disorders, (2) describes factors affecting the emergence of behavioral and emotional problems, (3) articulates the current state of detection of these problems in pediatric primary care, (4) describes barriers to screening and means to overcome those barriers, and (5) discusses potential changes at a practice and systems level that are needed to facilitate successful behavioral and emotional screening. Highlighted and discussed are the many factors at the level of the pediatric practice, health system, and society contributing to these behavioral and emotional problems.
根据目前的估计，在美国，任何时候大约有 11%至 20%的儿童患有行为或情绪障碍，这是根据《精神障碍诊断与统计手册》第五版定义的。无论在美国的哪个地理位置，37%至 39%的儿童在 16 岁之前会被诊断出患有行为或情绪障碍。美国的卫生系统无法可靠地识别或治疗儿童和青少年的行为和情绪问题及相关担忧。本临床报告侧重于增加行为筛查的必要性，并提供了实践和卫生系统中潜在的改变，以及实现这一目标所需的研究。本报告还（1）回顾了行为和情绪障碍的流行情况，（2）描述了影响行为和情绪问题出现的因素，（3）阐述了这些问题在儿科初级保健中的当前检测情况，（4）描述了筛查的障碍以及克服这些障碍的方法，（5）讨论了在实践和系统层面上需要进行哪些改变，以促进成功的行为和情绪筛查。强调并讨论了儿科实践、卫生系统和社会层面上导致这些行为和情绪问题的许多因素。
