Integrated Department of Paediatrics, Mid and South Essex University Hospitals Group, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex, UK.
British Paediatric Surveillance Unit, Royal College of Paediatrics and Child Health, London, UK.
BMJ Paediatr Open. 2021 Feb 8;5(1):e000713. doi: 10.1136/bmjpo-2020-000713. eCollection 2021.
To ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or joint surveillance by the British Paediatric Surveillance Unit (BPSU) and Child and Adolescent Psychiatry Surveillance System (CAPSS).
An online survey of the 1120 members of the British Association of Community Child Health (BACCH) working in 169 Community Child Health (CCH) services in the UK.
A total of 245 community paediatricians responded to the survey. This represents 22% of members of BACCH but likely to have covered many of the 169 CCH units because participants could respond on behalf of other members in their unit. The survey showed that children and young people (CYP) with neurodevelopmental conditions presented more frequently to paediatrics than to Child and Adolescent Mental Health Services (CAMHS). In addition, a sizeable proportion of CYP with emotional difficulties presented to paediatricians (eg, 29.5% for anxiety/obsessive compulsive disorder (OCD), and 12.8% for depression)-mainly due to difficulty with accessing CAMHS. More than half of the community paediatricians are involved in the care of CYP with anxiety and OCD, while 32.3% are involved in the care of those with depression.
There is significant involvement of community paediatricians in the care of CYP with mental health conditions. Involvement is highest for neurodevelopmental conditions, but also significant for CYP with emotional difficulties. The implication of the findings for surveillance case ascertainment is that joint BPSU and CAPSS is recommended for surveillance studies of neurodevelopmental conditions. However, for emotional disorders, single or joint surveillance should be made based on the specific research question and the relative trade-offs between case ascertainment, and the additional cost and reporting burden of joint surveillance. Single CAPSS studies remain appropriate for psychosis and bipolar disorder.
确定社区儿科医生参与儿童心理健康状况护理的程度，以便确定哪些困难适合由英国儿科监测单位（BPSU）和儿童和青少年精神病学监测系统（CAPSS）单独或联合监测。
对英国社区儿童健康协会（BACCH）的 1120 名成员中的 169 名在英国社区儿童健康（CCH）服务机构工作的成员进行在线调查。
共有 245 名社区儿科医生对调查作出回应。这代表了 BACCH 成员的 22%，但可能已经涵盖了 169 个 CCH 单位中的许多单位，因为参与者可以代表他们单位中的其他成员作出回应。调查显示，神经发育障碍儿童和青少年（CYP）比儿童和青少年心理健康服务（CAMHS）更常就诊于儿科。此外，相当一部分情绪困难的 CYP 也会就诊于儿科医生（例如，焦虑/强迫症（OCD）的比例为 29.5%，抑郁的比例为 12.8%），主要是因为难以获得 CAMHS 的服务。超过一半的社区儿科医生参与了 CYP 焦虑和 OCD 的治疗，而 32.3%的医生参与了 CYP 抑郁的治疗。
社区儿科医生在儿童心理健康状况的护理中发挥了重要作用。参与度最高的是神经发育障碍，而情绪困难的 CYP 也有显著参与。调查结果对监测病例确定的影响是，推荐联合 BPSU 和 CAPSS 进行神经发育障碍的监测研究。然而，对于情绪障碍，应根据具体的研究问题以及病例确定、联合监测的额外成本和报告负担之间的相对权衡，单独或联合进行监测。单一的 CAPSS 研究仍然适用于精神病和双相情感障碍。
