Diagnosing Psychosocial Problems

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 899-901 ◽  
Author(s):  
Kelly J. Kelleher ◽  
Mark L. Wolraich
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Task Force ◽  
Psychosocial Problems ◽  
Robert Wood Johnson Foundation ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
American Academy Of Pediatrics ◽  
Primary Care Clinicians ◽  
And Child Health

In April 1996, the American Academy of Pediatrics (AAP) Task Force on Mental Health Coding for Children completed 4 years of work on the development of a classification system for children's mental health appropriate for primary care clinicians with the publication of the Diagnostic and Statistical Manual for Primary Care—Child Version (DSM-PC). This work represents a multidisciplinary effort spearheaded by the AAP and supported by grants from the Bureau of Maternal and Child Health, the Robert Wood Johnson Foundation, and the Friends of Children Fund to create a more prevention-oriented, developmentally based system for classifying psychosocial diagnoses of children and adolescents in primary care with mental health symptoms.

How Do Primary Care Clinicians Manage Childhood Mood and Anxiety Syndromes?

2005 ◽  
Vol 35 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Frances J. Wren ◽  
Sarah H. Scholle ◽  
Jungeun Heo ◽  
Diane M. Comer
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
Puerto Rico ◽  
Care Management ◽  
Psychosocial Problems ◽  
The United States ◽  
Primary Care Clinicians ◽  
Primary Care Management

Objective: To describe how primary care clinicians manage children in whom they diagnose mood or anxiety syndromes. Method: This study is a secondary analysis of data from the multi-site Child Behavior Study (CBS)—a cross-sectional survey of primary care management of psychosocial problems. The management of children in whom clinicians identified mood or anxiety syndromes is described and compared with the management of children in whom they identified other psychosocial problems. Recruitment for the CBS occurred in 206 primary care practices in the United States, Puerto Rico, and Canada from October 1994 through June 1997. Participants were 20,861 consecutively sampled primary care attendees aged 4–15 years and 395 clinicians. Primary outcome measures for this report are rates of referral to specialized mental health care and rates of active primary care management (i.e., scheduling a follow-up appointment and/or providing ongoing counseling and/or psychotropic prescription). Results: Identification of a mood or anxiety syndrome was associated with increased rates of referral to mental health compared with rates for children with other psychosocial problems. There was no effect on the proportion of children counseled during the visit. In fact, unless accompanied by a co-morbid behavioral syndrome, children receiving the diagnosis of a mood or anxiety syndrome were less likely to be offered a scheduled follow-up appointment. Rates of prescription of antidepressants or anti-anxiety agents were higher for mood/anxiety groups but this was still uncommon (6.7%). Conclusions: Active management of childhood mood and anxiety syndromes in primary care was uncommon in the United States, Puerto Rico, and Canada in the mid-1990s.

Challenging care work: General practitioners’ perspectives on caring for young adults with complex psychosocial problems

2019 ◽  
pp. 136345931987410
Author(s):  
Julie Høgsgaard Andersen ◽  
Tine Tjørnhøj-Thomsen ◽  
Susanne Reventlow ◽  
Annette Sofie Davidsen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young Adults ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
Health Problems ◽  
Care Work ◽  
Psychiatric Nurses ◽  
Provision Of Care

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners’ perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners’ care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto’s concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults’ difficulties with accessing and receiving available care.

Uninsured Children With Psychosocial Problems: Primary Care Management

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 930-936 ◽  
Author(s):  
Thomas K. McInerny ◽  
Peter G. Szilagyi ◽  
George E. Childs ◽  
Richard C. Wasserman ◽  
Kelly J. Kelleher
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
The United States ◽  
Behavior Study ◽  
Care Practices ◽  
Uninsured Children ◽  
Primary Care Practices

Objective. Nearly 14% of children in the United States are uninsured. We compared the prevalence of psychosocial problems and mental health services received by insured and uninsured children in primary care practices. Methods. The Child Behavior Study was a cohort study conducted by Pediatric Research in Office Settings and the Ambulatory Sentinel Practice Network. Four hundred one primary care clinicians enrolled an average sample of 55 consecutive children (4–15 years old) per clinician. Results. Of the 13 401 visits to clinicians with 3 or more uninsured patients, 12 518 were by insured children (93.4%) and 883 were by uninsured children (6.6%). A higher percentage of adolescents, Hispanic children, those with unmarried parents, and those with less educated parents were uninsured. According to clinicians, uninsured children and insured children had similar rates of psychosocial problems (19%) and severe psychosocial problems (2%). For children with a clinician-identified psychosocial problem, we found no differences in clinician-reported counseling, medication use, or referral to mental health professionals. Conclusions. Among children served in primary care practices, uninsured children have similar prevalence of clinician-identified psychosocial and mental health problems compared with insured children. Within their practices, clinicians managed uninsured children much the same way as insured children.psychosocial problems, uninsured children, pediatrics, family medicine, primary care.

scholarly journals Revising Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for the bipolar disorders: Phase I of the AREDOC project

2018 ◽  
Vol 52 (12) ◽  
pp. 1173-1182 ◽  
Author(s):  
Gordon Parker ◽  
Gabriela Tavella ◽  
Glenda Macqueen ◽  
Michael Berk ◽  
Heinz Grunze ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Task Force ◽  
Bipolar Disorders ◽  
International Classification Of Diseases ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Operational Criteria ◽  
International Experts

Objective: To derive new criteria sets for defining manic and hypomanic episodes (and thus for defining the bipolar I and II disorders), an international Task Force was assembled and termed AREDOC reflecting its role of Assessment, Revision and Evaluation of DSM and other Operational Criteria. This paper reports on the first phase of its deliberations and interim criteria recommendations. Method: The first stage of the process consisted of reviewing Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and recent International Classification of Diseases criteria, identifying their limitations and generating modified criteria sets for further in-depth consideration. Task Force members responded to recommendations for modifying criteria and from these the most problematic issues were identified. Results: Principal issues focussed on by Task Force members were how best to differentiate mania and hypomania, how to judge ‘impairment’ (both in and of itself and allowing that functioning may sometimes improve during hypomanic episodes) and concern that rejecting some criteria (e.g. an imposed duration period) might risk false-positive diagnoses of the bipolar disorders. Conclusion: This first-stage report summarises the clinical opinions of international experts in the diagnosis and management of the bipolar disorders, allowing readers to contemplate diagnostic parameters that may influence their clinical decisions. The findings meaningfully inform subsequent Task Force stages (involving a further commentary stage followed by an empirical study) that are expected to generate improved symptom criteria for diagnosing the bipolar I and II disorders with greater precision and to clarify whether they differ dimensionally or categorically.

Mental Health Care of Children and Adolescents: A Guide for Primary Care Clinicians

2018 ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Children And Adolescents ◽  
Primary Care Practice ◽  
Care Practice ◽  
Primary Care Clinicians

This indispensable resource provides vital guidance for integrating mental health care into your everyday primary care practice. https://shop.aap.org/mental-health-care-of-children-and-adolescents-a-guide-for-primary-care-clinicians-paperback/

Psychosis in Primary Care

2009 ◽  
Vol 2 (6) ◽  
pp. 364-371
Author(s):  
Alan Cohen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Bipolar Disorder ◽  
Acute Psychosis ◽  
Outcome Framework ◽  
Practice Of Medicine ◽  
Primary Care Clinicians ◽  
Epidemiological Characteristics ◽  
Chronic Psychosis

This paper describes the role of primary care clinicians in the management of people with psychosis. The paper uses the term ‘psychosis’ in the same way that severe mental illness is used in the Quality and Outcome Framework to mean those people who suffer from schizophrenia or bipolar disorder. The paper will cover some epidemiological characteristics of psychosis, features of people with acute psychosis, features of chronic psychosis and finally describe briefly changes to the Mental Health Act 2007 and the potential for these changes to affect the practice of medicine in primary care.

Evaluating the Usefulness of DSM in Diagnosing Mental Health Problems: A Review of the Literature

2016 ◽  
Vol 6 (1) ◽  
pp. 46-51
Author(s):  
Basak Baglama
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Recent Literature ◽  
Health Problems ◽  
Analysis Method ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm V

Understanding the needs of indivudals with mental disabilities is really important in terms of improving quality of life, intervention and promotion. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is widely used book for mental health professionals in order to make diagnosis. The present study discusses the usefulness of DSM in diagnosing mental health problems by emphasizing it’s advantages and criticisms. This study used document analysis method in order to provide an overview and discussion of recent literature regarding advantages and criticisms of DSM. Various issues have been discussed and conclusions have been made based on the literature review of this study. 

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