Beyond ADHD: How Well Are We Doing?

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• 作者：Ruth E.K. Stein ; MD^a ; ^{ruth.stein@einstein.yu.edu" class="auth_mail" title="E-mail the corresponding author} ; Amy Storfer-Isser ; PhD^b ; Bonnie D. Kerker ; PhD^c ; ^d ; Andrew Garner ; MD ; PhD^e ; Moira Szilagyi ; MD ; PhD^f ; Kimberly E. Hoagwood ; PhD^c ; Karen G. O'Connor ; BS^g ; Sarah McCue Horwitz ; PhD^c
• 关键词：ADHD ; anxiety ; behavior problems ; depression ; developmental behavioral pediatrics ; learning problems ; mental health ; screening
• 刊名：Academic Pediatrics
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：16
• 期：2
• 页码：115-121
• 全文大小：186 K

文摘

There has been increasing emphasis on the role of the pediatrician with respect to behavioral, learning, and mental health (MH) issues, and developmental behavioral rotations are now required in pediatric residency programs. We sought to examine whether this newer emphasis on MH is reflected in pediatricians' reports of their current practices.

Methods

Data from 2 periodic surveys conducted in 2004 and 2013 by the American Academy of Pediatrics were examined to see whether there were differences in self-reported behaviors of usually inquiring/screening, treating/managing/comanaging, or referring patients for attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, behavioral problems, or learning problems. We examined patterns for all practicing members and for those who practiced general pediatrics exclusively.

Results

There were few changes over the decade in the percentage who inquired or screened among all clinicians; among those exclusively practicing general pediatrics, the percentage who inquired or screened increased about 10% for ADHD and depression. ADHD remained the only condition for which the majority of respondents treated/managed/comanaged (57%). While there was some increase in the percentages who treated other conditions, the other conditions were usually treated by <30% of respondents. A similar pattern of results was observed in analyses adjusted for physician, practice, and patient characteristics.

Conclusions

Despite the changing nature of pediatric practice and increased efforts to emphasize the importance of behavior, learning, and MH, the pediatric community appears to be making little progress toward providing for the long-term behavioral, learning, and MH needs of children and adolescents in its care.