Weniger Max, Beesdo-Baum Katja, Ernst Julia, Siegmund Cornelia Beate, Porst Patricia Theresa, McDonald Maria, Roessner Veit, Knappe Susanne
Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland.
Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Sachsen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Jan;67(1):23-35. doi: 10.1007/s00103-023-03787-0. Epub 2023 Nov 3.
Mental health problems usually have their onset in childhood. Undiagnosed, they may progress into mental disorders. Despite their effectiveness, existing preventive programs have been rarely used. We aimed to examine to what extent the establishment of a care chain can identify children at high risk at an early stage and assign them to preventive interventions. In addition, prevention program participation was assessed.
In a prospective implementation study, the Strengths and Difficulties Questionnaire was administered as a screening instrument to families during regular pediatric health examinations (U9-U11, child age 5-10 years). Families received feedback directly from the pediatrician, and in the case of borderline abnormal emotional or behavioral problems, a recommendation for an indicative prevention program. Program indication was additionally determined in an entry examination prior to program participation.
In the area of Dresden (Germany), n = 46 (38.7%) pediatricians participated in the project. In n = 28 pediatric practices, n = 3231 (86.4%) families participated in the screening and n = 864 (26.7%) children received a prevention recommendation. Of the families, n = 118/864 (13.7%) self-registered for the prevention programs, n = 215/624 (35.5%) showed interest after being contacted by the study teamn. Through other pathways, n = 139 families requested participation. Clinical evaluation interviews to assess prevention indication were conducted in n = 337 children (n = 461; via all entry pathways). Finally, n = 237 (n = 337) children participated in an indicated prevention program.
Expanding screening to mental health problems during regular health checkups is feasible, useful, and widely accepted. In order to implement a care chain, a supply structure should be established to enable referral to and uptake of preventive interventions.
心理健康问题通常始于童年。若未被诊断出来，可能会发展为精神障碍。尽管现有预防项目有效，但很少被采用。我们旨在研究建立一个照护链在多大程度上能够在早期识别高危儿童并为其分配预防性干预措施。此外，还评估了预防项目的参与情况。
在一项前瞻性实施研究中，在常规儿科健康检查（U9 - U11，儿童年龄5 - 10岁）期间，向家庭发放优势与困难问卷作为筛查工具。家庭直接从儿科医生那里获得反馈，对于情绪或行为问题处于临界异常的情况，会收到参加指示性预防项目的建议。在参加项目前的入学检查中还会额外确定项目指示。
在德累斯顿地区（德国），n = 46（38.7%）名儿科医生参与了该项目。在n = 28个儿科诊所中，n = 3231（86.4%）个家庭参与了筛查，n = 864（26.7%）名儿童收到了预防建议。在这些家庭中，n = 118/864（13.7%）自行登记参加预防项目，n = 215/624（35.5%）在研究团队联系后表示有兴趣。通过其他途径，有n = 139个家庭请求参与。对n = 337名儿童（n = 461；通过所有入学途径）进行了评估预防指示的临床评估访谈。最后，n = 237（n = 337）名儿童参加了指示性预防项目。
在常规健康检查中扩大对心理健康问题的筛查是可行、有用且被广泛接受的。为了实施照护链，应建立一个供应结构，以实现转诊并接受预防性干预措施。
