Department of General Practice, Erasmus Medical Centre, the Netherlands.
Department of General Practice, Erasmus Medical Centre, the Netherlands; Department of General Practice and Family Medicine, University of Bielefeld, Bielefeld, Germany.
Br J Gen Pract. 2022 May 26;72(719):e405-e412. doi: 10.3399/BJGP.2021.0557. Print 2022 Jun.
Due to a large strain on youth mental health care, general practice is suggested as an alternative treatment setting for children and adolescents with anxiety problems. However, research on the current management of these children and adolescents within general practice is scarce.
To investigate the incidence of coded anxiety in general practice using the International Classification of Primary Care (ICPC), and GPs' management of children and adolescents presenting with anxiety problems.
Population-based cohort study using electronic medical records of 51 212 children (aged 0-17 years) in primary care in the Rotterdam region between 1 January 2012 and 31 December 2018.
Incidence of ICPC codes for anxiety were calculated, then the characteristics of children and adolescents consulting their GP with anxiety and the GPs' management were assessed qualitatively using quantitative content analysis.
Incidence of ICPC codes for anxiety in children and adolescents was 5.36 (95% confidence interval [CI] = 5.02 to 5.71) per 1000 person-years. Adolescent females had the highest incidence with 14.01 (95% CI = 12.55 to 15.58) per 1000 person-years. Of the 381 children and adolescents consulting their GP with an initial anxiety problem (median age 13.3 years, 40.4% male), GPs referred 59.3% to mental health care in the first year while 26.5% of children and adolescents were managed by a specialised practice nurse within general practice. Of the 381 children and adolescents, 10.5% received psychiatric medication during the first year, with the trend being for increased prescriptions during adolescence.
In general practice children and adolescents frequently received one of two ICPC codes for anxiety, especially adolescent females. Most presenting to their GP with anxiety problems are referred externally or seen by a specialised practice nurse within general practice.
由于年轻人的心理健康护理压力很大，一般实践被建议作为儿童和青少年焦虑问题的替代治疗环境。然而，关于一般实践中这些儿童和青少年的当前管理的研究很少。
使用国际初级保健分类（ICPC）调查一般实践中编码焦虑的发生率，以及全科医生对出现焦虑问题的儿童和青少年的管理。
这是一项基于人群的队列研究，使用了 2012 年 1 月 1 日至 2018 年 12 月 31 日在鹿特丹地区初级保健中 51212 名（0-17 岁）儿童的电子病历。
计算 ICPC 焦虑编码的发生率，然后使用定量内容分析定性评估咨询全科医生有焦虑症状的儿童和青少年的特征以及全科医生的管理。
儿童和青少年的 ICPC 焦虑编码发生率为每 1000 人年 5.36（95%置信区间[CI] = 5.02-5.71）。青春期女性的发生率最高，为每 1000 人年 14.01（95% CI = 12.55-15.58）。在 381 名因初始焦虑问题咨询全科医生的儿童和青少年中（中位数年龄 13.3 岁，40.4%为男性），全科医生在第一年将 59.3%转介到精神保健，而 26.5%的儿童和青少年由普通实践中的专门护士管理。在 381 名儿童和青少年中，10.5%在第一年接受了精神科药物治疗，青春期时处方呈上升趋势。
在一般实践中，儿童和青少年经常出现两种 ICPC 焦虑编码之一，尤其是青春期女性。大多数因焦虑问题就诊的儿童和青少年都被转介到外部机构，或由普通实践中的专门护士治疗。
