Garralda M Elena, Slaveska-Hollis Karmen
The Centre for Mental Health, Imperial College London, Hammersmith Campus, du Cane Road, London W12 0NN, UK.
Paediatric Liaison Service, Nottingham Children's Hospital, Department of Child and Adolescent Psychiatry, South Block, E floor, QMC Nottingham, UK.
Child Adolesc Ment Health. 2016 May;21(2):96-101. doi: 10.1111/camh.12146. Epub 2016 Jan 22.
The paediatric population is known to be at high risk for psychiatric problems. Paediatric liaison child/adolescent mental health services (PL-CAMHS) have been developed to help increase recognition and management of psychiatric morbidity in the paediatric setting. This report describes clinical activity by a psychological medicine PL-CAMHS and considers specificity by comparing this with community/general CAMHS activity.
Clinical information was obtained on consecutive patients seen by a PL-CAMHS in a UK tertiary specialist hospital. Where feasible this was compared with published data on national/community CAMHS work.
Data was obtained on 800 patients (mean age 11.9, SD 3.8). Most referrals came from a variety of paediatric teams, nearly two-thirds were for psychosomatic problems or difficulties adjusting to physical illness. The majority had an ICD-10 psychiatric diagnosis (mostly adjustment, mood and anxiety, and somatoform disorders); problems were often complex and in about half, family difficulties were also noted; one-third had received prior mental health treatment. Virtually all children were seen by the PL service within a month of referral and only 2% of families failed to attend for assessment. Some level of clinical improvement was noted for the majority. There were indications of differences from national/community CAMHS work in referral source, take up rates and psychiatric diagnoses.
Paediatric liaison child and adolescent mental health services users commonly have characteristic psychiatric problems, interventions appear potentially effective and the work is specific and complementary of community CAMHS. Thus PL-CAMHS make a distinct contribution to the provision of truly comprehensive CAMHS.
已知儿科人群患精神疾病的风险很高。儿科联络儿童/青少年心理健康服务（PL-CAMHS）已得到发展，以帮助提高对儿科环境中精神疾病的识别和管理。本报告描述了心理医学PL-CAMHS的临床活动，并通过将其与社区/普通CAMHS活动进行比较来考虑其特殊性。
获取了英国一家三级专科医院PL-CAMHS诊治的连续患者的临床信息。在可行的情况下，将其与国家/社区CAMHS工作的已发表数据进行比较。
获取了800名患者的数据（平均年龄11.9岁，标准差3.8）。大多数转诊来自各种儿科团队，近三分之二是因为身心问题或难以适应身体疾病。大多数患者有ICD-10精神疾病诊断（主要是适应障碍、情绪和焦虑以及躯体形式障碍）；问题通常很复杂，约一半患者还存在家庭困难；三分之一的患者曾接受过心理健康治疗。几乎所有儿童在转诊后一个月内都接受了PL服务，只有2%的家庭未前来评估。大多数患者有一定程度的临床改善。在转诊来源、接受率和精神疾病诊断方面，有迹象表明与国家/社区CAMHS工作存在差异。
儿科联络儿童和青少年心理健康服务的使用者通常有典型的精神疾病问题，干预措施似乎有潜在效果，且该工作具有特殊性，是对社区CAMHS的补充。因此PL-CAMHS为提供真正全面的CAMHS做出了独特贡献。
