Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, California, USA.
Infant Ment Health J. 2023 May;44(3):362-371. doi: 10.1002/imhj.22054. Epub 2023 Mar 23.
The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-5) was developed to provide a framework for diagnosis of infants and young children, and a training curriculum supports implementation of the manual in clinical practice. This study surveyed 100 mental health clinicians (93% female and 53% Latinx/Hispanic) who had completed training in the DC: 0-5 classification system and worked with infants/young children and their families primarily in urban, public insurance-funded, community mental health settings in the United States. The survey explored their use of the diagnostic manual in clinical practice as well as supports and barriers to implementation. Survey results indicated a high level of adoption of the manual in clinical practice, although all five axes and the cultural formulation were used less often than the Axis I Clinical Disorders section. Barriers to implementation included systemic issues such as agency and billing requirements necessitating simultaneous use of other diagnostic manuals, lack of supports and expertise within their agency, and difficulty making time to fully utilize the manual. The findings suggest that policy and systems changes may be needed to enable clinicians to fully integrate the DC: 0-5 into their case conceptualizations.
《婴幼儿心理健康与发育障碍诊断分类》（DC：0-5）旨在为婴幼儿的诊断提供框架，并提供了一个培训课程以支持该手册在临床实践中的应用。本研究调查了 100 名接受过 DC：0-5 分类系统培训的心理健康临床医生（93%为女性，53%为拉丁裔/西班牙裔），他们主要在美国城市、公共保险资助的社区心理健康环境中为婴儿/幼儿及其家庭提供服务。该调查探讨了他们在临床实践中使用诊断手册的情况，以及实施的支持和障碍。调查结果表明，该手册在临床实践中得到了广泛应用，尽管所有五个轴和文化构念的使用频率都低于轴 I 临床障碍部分。实施的障碍包括机构和计费要求等系统问题，需要同时使用其他诊断手册，机构内缺乏支持和专业知识，以及难以抽出时间充分利用该手册。研究结果表明，可能需要进行政策和系统变革，以使临床医生能够将 DC：0-5 充分融入其病例概念化。
