a Department of Public Health and Primary Care, Leiden University Medical Centre , Leiden , The Netherlands.
b Centre for Longitudinal Research-He Ara ki Mua, The University of Auckland , Auckland , New Zealand.
Eur J Gen Pract. 2019 Jul;25(3):116-127. doi: 10.1080/13814788.2019.1623199. Epub 2019 Jun 27.
Although common and often with long-lasting effects, child mental health problems (MHPs) are still under-recognized and under-treated. A better understanding of the factors associated with the identification of MHPs in primary care may improve the recognition of MHPs. To review studies on factors associated with the identification of child MHPs in primary care. Six leading databases were systematically searched until 1 October 2018. Two independent researchers selected articles and extracted data on study characteristics and factors associated with MHP identification. Inclusion criteria were the investigation of factors associated with MHP identification by primary care professionals (PCPs) in children aged 0-18 years. Of the 6215 articles identified, 26 were included. Prevalence rates of PCP-identified MHPs varied between 7 and 30%. PCPs identified 26-60% of children with an increased risk of MHPs as indicated by MHP assessment tools, but associated factors were investigated in relatively few studies. MHPs were more often identified in children with a family composition other than married parents, with worse mental health symptoms, prior MHPs, among boys in elementary school, when contact with PCPs was related to parental psychosocial concerns or routine health check-ups, when PCPs were recently trained in MHPs or when PCPs felt less burdened treating MHPs. MHP identification varied substantially between studies and PCPs and was related to several child, family and practice factors. Future studies should systematically investigate factors associated with MHP identification by PCPs and specifically in children with an increased risk of MHPs according to mental health assessment tools.
尽管儿童心理健康问题（MHP）很常见且往往具有持久影响，但仍未得到充分认识和治疗。更好地了解与初级保健中识别 MHP 相关的因素可能会提高对 MHP 的识别率。本研究旨在综述与初级保健中识别儿童 MHP 相关的因素的研究。系统检索了 6 个主要数据库，截至 2018 年 10 月 1 日。两名独立的研究人员选择了与研究特征和与 MHP 识别相关的因素相关的文章，并提取了数据。纳入标准为调查初级保健专业人员（PCP）在 0-18 岁儿童中识别 MHP 相关因素的研究。在确定的 6215 篇文章中，有 26 篇符合纳入标准。PCP 识别的 MHP 患病率在 7%至 30%之间不等。PCP 使用 MHP 评估工具识别出 26%至 60%有较高 MHP 风险的儿童，但很少有研究调查相关因素。在有非已婚父母家庭组成、心理健康症状较差、先前有 MHP、小学男生、与 PCP 的接触与父母心理社会问题或常规健康检查有关、PCP 最近接受过 MHP 培训或 PCP 治疗 MHP 负担较轻的儿童中，MHP 更常被识别。研究间和 PCP 间的 MHP 识别差异很大，与儿童、家庭和实践的几个因素有关。未来的研究应系统地调查与 PCP 识别 MHP 相关的因素，并根据心理健康评估工具专门调查有较高 MHP 风险的儿童的相关因素。
