Biederman Joseph, DiSalvo Maura, Vaudreuil Carrie, Wozniak Janet, Uchida Mai, Yvonne Woodworth K, Green Allison, Faraone Stephen V
Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Scand J Child Adolesc Psychiatr Psychol. 2020 Oct 31;8:157-165. doi: 10.21307/sjcapp-2020-016. eCollection 2020.
Little is known about the scope of problems driving referrals to child and adolescent psychiatry services. Identifying the full range of mental disorders affecting a particular child can help triage the child to a clinician with the appropriate level of expertise. The Child Behavior Checklist (CBCL) is an easy-to-use assessment tool that may provide invaluable information regarding the severity of the presenting complaints and also aid in the referral process.
To assess the utility of the CBCL to gain insights into the type of clinical problems driving referrals of youth to an outpatient pediatric psychiatry clinic.
The sample consisted of 418 newly referred youth 4-18 years of age of both sexes. Parents completed the CBCL assessing psychopathology and competence. Rates of patients with elevated T-scores on each scale were calculated for the whole group and stratified by sex and age (≤12 versus >12).
The CBCL identified high rates of psychopathology affecting referred youth. It also provided information on the type of suspected disorders affecting a particular child as well as their severity, critical information to guide likely differing clinical needs and therapeutic approaches. It also helped identify a high number of youth affected with multiple psychopathological conditions, likely to require a high level of clinical attention. Overall, males were significantly more impaired than females but there were no major differences between children and adolescents.
The CBCL can aid in the identification of individual and comorbid mental disorders affecting youth seeking mental health services by providing specific information about the presence and the severity of specific suspected disorder. These findings have implications for prioritizing scarce resources in child mental health and for improved consideration of the complexity of clinical presentations to pediatric psychiatry programs of any type.
关于促使儿童和青少年转诊至精神科服务的问题范围，人们了解甚少。识别影响特定儿童的所有精神障碍有助于将该儿童分诊至具备适当专业水平的临床医生处。儿童行为检查表（CBCL）是一种易于使用的评估工具，可能会提供有关当前症状严重程度的宝贵信息，也有助于转诊过程。
评估CBCL在深入了解促使青少年转诊至门诊儿科精神科诊所的临床问题类型方面的效用。
样本包括418名新转诊的4至18岁青少年，男女均有。家长完成了评估精神病理学和能力的CBCL。计算了整个组以及按性别和年龄（≤12岁与>12岁）分层的每个量表上T分数升高的患者比例。
CBCL识别出影响转诊青少年的高精神病理学发生率。它还提供了有关影响特定儿童的疑似障碍类型及其严重程度的信息，这是指导可能不同的临床需求和治疗方法的关键信息。它还帮助识别出大量受多种精神病理状况影响的青少年，这些青少年可能需要高水平的临床关注。总体而言，男性的受损程度明显高于女性，但儿童和青少年之间没有重大差异。
CBCL可以通过提供有关特定疑似障碍的存在和严重程度的具体信息，帮助识别影响寻求心理健康服务的青少年的个体和共病精神障碍。这些发现对于优先分配儿童心理健康方面的稀缺资源以及更好地考虑任何类型的儿科精神科项目中临床表现的复杂性具有重要意义。
