Abstract
International appreciation of the tremendous burden placed on individuals, families, and societies as a result of mental disorders increased greatly in the last decade. This appreciation extends to the heavy burden that pediatric emotional disorders comprise as well. Unfortunately, specialty mental health services will never be adequate to address the pandemic of pediatric mental disorders even in countries with the greatest healthcare resources. This is in large part because of the global shortage of pediatric mental health clinicians (Mechanic 1996; Deva 1981). In addition, many if not most cultures do not have a history of using specialty mental health services. Such services may be associated with negative stereotypes and stigma. In addition, mental health care may be paid almost completely out of pocket (Maingay 2002).
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Abas M, Baingana F, Broadhead J, Iacoponi E, Vanderpyl J. Common mental disorders and primary health care: current practice in low-income countries. Harv Rev Psychiatry 2003 May–Jun;11(3):166–173.
Abiodun OA. Mental health and primary care in Africa. East Afr Med J. 1990 Feb;67(4):273–278.
Achenbach System of Empirically Based Assessment (ASEBA). http://www.aseba.org/aboutus/origins.html 12/1/03
Angold A, Costello EJ, Farmer EM, Burns BJ, Erkanli A. Impaired but undiagnosed. J Am Acad Child Adolesc Psychiatry 1999 Feb;38(2):129–137.
Arnold LE, Elliot M, Sachs L, Bird H, Kraemer HC, Wells KC, Abikoff HB, Comarda A, Conners CK, Elliott GR, Greenhill LL, Hechtman L, Hindshaw SP, Hoza B, Jensen PS, March JS, Newcorn J H, Pelham WE, Severe J B, Swanson J M, Vitiello B, Wigal T. Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD. J Consult Clin Psychol 2003 Aug;71(4):713–727.
Bailey V, Graham P, Boniface D (1978) How much child psychiatry does a general practitioner do? Journal of the Royal College of General Practitioners, 28, 621–626.
Banazak D A, Wills C, Collins C. Late-life depression in primary care: where do we go from here? J Am Osteopath Assoc. 1998 Sep;98(9):489–497.
Berg G D, S Wadhwa (2002) “Diabetes disease management in a community-based setting.” Manag Care 11(6):42, 45–50.
Bower P. Primary Care mental health workers: models of working and evidence of effectiveness. Br J Gen Pract 2002 Nov;52(484):926–933.
Bower P, Sibbald B. On-site mental health workers in primary care: effects on professional practice. Cochrane Database Syst Rev. 2000;(3):CD000532.
Bower P, Garralda E, Kramer T, Harrington R, Sibbald B. The treatment of child and adolescent mental health problems in primary care: a systematic review. Fam Pract 2001 Aug;18(4):373–382.
Briggs-Gowan M J, Horwitz SM, Schwab-Stone ME, Leventhal J M, Leaf PJ. Mental health in pediatric settings: distribution of disorders and factors related to service use. J Am Acad Child Adolesc Psychiatry 2000 Jul;39(7):841–849.
Briggs-Gowan MJ, Owens PL, Schwab-Stone ME, Leventhal JM, Leaf P, Horwitz SM. Peristence of Psychiatric Disorders in Pediatric Settings. J Am Acad Child Adolesc Psychiatry 2003 Nov;42(11):1360–1369.
Brown C, Dunbar-Jacob J, Palenchar DR, Kelleher KJ, Bruehlman R D, Sereika S, Thase M E. Primary care patients’ personal illness models for depression: a preliminary investigation. Journal of Family Medicine 2001;18(3):314–320.
Cadman D, Boyle M, Szatmari P, Offord D R. Chronic illness, disability, and mental and social well-being: findings of the Ontario Child Health Study. Pediatrics 1987 May;79(5):805–813.
Campo JV, Comer D M, Jansen-McWilliams L, Gardner W, Kelleher KJ. Recurrent pain, emotional distress, and health service use in childhood. J Pediatr 2002 July;141(1):76–83.
Connell S, Sanders MR, Markie-Dadds C. Self-directed behavioral family intervention for parents of oppositional children in rural and remote areas. Behav Modif 1997 Oct;21(4):379–408.
Cooper-Patrick L, Gallo JJ, Powe N R, Steinwachs DM, Eaton WW, For D E. Mental health service utilization by African Americans and Whites: the Baltimore Epidemiologic Catchment Area Follow-Up. Med Care 1999 Oct;37(10):1034–1045.
Costello EJ. Psychopathology in pediatric primary care: the new hidden morbidity. Pediatrics 1988 Sep;82(3 Pt 2):415–424.
Costello EJ. Child psychiatric disorders and their correlates: a primary care pediatric sample. J Am Acad Child Adolesc Psychiatry 1989 Nov;28(6):851–855.
Datto C, Thompson R, Horowitz D, Disbot M, Oslin D. The pilot study of a telephone disease management program for depression. General Hospital Psychiatry 25 (2003):169–177.
Deva M P. Training of psychiatrists for developing countries. Aust N Z J Psychiatry 1981 Dec;15(4): 343–347.
Donaldson M, Yordy K, Lohr K, Vanselow N. Front Matter. Primary Care: America’s Health in a new Era. Institute of Medicine (1996) pp i–x.
Durand MA, King M. Specialist treatment versus self-help for bulimia nervosa: a randomized controlled trial in general practice. Br J Gen Pract 2003 May;53(490):371–377.
Farvolden P, McBride C, Bagby RM, Ravitz P. A Web-based screening instrument for depression and anxiety disorders in primary care. Journal of Medical Internet Research. 5(3):e23 2003 Jul–Sep.
Flisher AJ, Kramer RA, Grosser RC, Alegria M, Bird H R, Bourdon KH, Goodman SH, Greenwald S, Horwitz SM, Moore RE, Narrow WE, Noven CW. Correlates of unmet need for mental health services by children and adolescents. Psychol Med 1997 Sept;27(5):1145–1154.
Fritz G K, Bergman AS. Child psychiatrists’ characteristics, communication, and competence as described by pediatricians in a national survey. Int J Psychiatry Med 1986-87;16(1):91–100.
Gabbay M, Shiels C, Bower P, Sibbald B, King M, Ward E. Patient-practitioner agreement: does it matter? Psychological Medicine 2003, 33, 241–251.
Galan S, Delgado M T, Sanz C, Cordoba R. Family medicine research: analysis of papers accepted at national and international congresses. Aten Primaria 1995 Mar 15;(4):239–42, 244.
Gardner W, Murphy M, Childs C, Kelleher K, Pagano M, Jellinek M, et al. The PSC 17: a brief pediatric symptom checklist with psychosocial problem subscales, A report from PROS and ASPN. Ambulatory Child Health 1999;5(3):225–236.
Gardner W, Kelleher KJ, Wasserman R, Childs G, Nutting P, Lillienfeld H, Pajer K. Primary care treatment of pediatric psychosocial problems: A study from PROS and ASPN. Pediatrics 2000;106(4):e44.
Gardner W, Kelleher KJ, Pajer KA. Multidimensional adaptive testing for mental health problems in primary care. Medical Care 2002;40(9), 812–823.
Gardner W, Kelleher KJ, Page KA, Campo JV. Primary care clinicians’ use of standardized tools to assess child psychosocial problems. Ambulatory Pediatrics, July–Aug 2003, 3 (4) 191–195.
Garralda E. Child and adolesecent psychiatry in general practice. Aust N Z J Psychiatry 2001 Jun:35(3): 308–314.
Gask L, Usherwood T, Thompson H, Williams B. Evaluation of a training package in the assessment and management of depression in primary care. Med Educ 1998 Mar;32(2):190–198.
Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 2003 Jun 18;289(23):3145–3151.
Goldberg ID, Roghmann KJ, McInerny TK, Burke JD Jr. Mental health problems among children seen in pediatric practice: prevalence and management. Pediatrics 1984 Mar;73(3):278–293.
Hirschfeld RM, Keller MB, Panico S, Arons BS, Barlow D, Davidoff F, Endicott J, Froom J, Goldstein M, Gorman JM, Marek RG, Maurer TA, Meyer R, Phillips K, Ross J, Schwenk TL, Sharfstein SS, Thase ME, Wyatt RJ. The National Depressive and Manic-Depressive Association consensus statement on the under treatment of depression. JAMA 1997 Jan 22–29;277(4):333–340.
Hoagwood K, Kelleher KJ, Feil M, Comer D. Treatment services for children with ADHD: A national perspective. J Am Acad Child Adolesc Psychiatry 2000;39(2):198–206.
Holm S, Liss PE, Norheim OF. Access to health care in the Scandinavian countries: ethical aspects. Health Care Anal 1999;7(4):321–330.
Horwitz SM, Kelleher KJ, Boyce T, Jensen P, Murphy M, Perrin E, Stein R E K, Weitzman M. Barriers to health care for children and youth with psychosocial problems. JAMA 2002, 288(12):1508–1512.
Jellinek MS, Murphy JM, Little M, Pagano ME, Comer DM, Kelleher KJ. Use of the Pediatric Symptom Checklist to screen for psychosocial problems in pediatric primary care: a national feasibility study. Arch Pediatr Adolesc Med 1999 Mar;153(3):254–260.
Katz R, Stephen J, Shaw BF, Matthew A, Newman F, Rosenbluth M. The East York Health Needs Study. I: Prevalence of DSM-III-R psychiatric disorder in a sample of Canadian women. Br J Psychiatry. 1995 Jan;166(1):100–106.
Kelleher K., Hohmann A, Larson D: Prescription of psychotropic drugs in office based practices. American Journal of Diseases of Children 1989;143:855–859.
Kelleher KJ, Wolraich ML. Diagnosing psychosocial problems. Pediatrics 1996 June;97(6 Pt 1):899–901.
Kelleher KJ, McInerny TK, Gardner WP, Childs GE, Wasserman R C. Increasing identification of psychosocial problems: 1979–1996. Pediatrics 2000;105(6):1313–1321.
Kelleher KJ, Childs GE, Wasserman RC, McInerny TK, Nutting PA, Gardner WP. Insurance status and recognition of psychosocial problems: A report from PROS and ASPN. Archives of Pediatric & Adolescent Medicine. 1997;151:1109–1115.
Kelleher KJ, Moore CD, Childs GE, Angelilli ML, Comer DM. Patient race and ethnicity in primary care management of child behavior problems. Medical Care 1999;37(11): 1092–1104.
Kelleher KJ, Childs GE, Harman J S. Health care costs for children with Attention Deficit/Hyperactivity Disorder. The Economics of Neuroscience 2001;3(4):60–63.
Kovacs M. The Children’s Depression Inventory. http://assessmentsstage. ncspearson.com/assessments/tests/cdi.htm 12/1/03
Lave J R, Peele P B, Xu Y, Scholle S H, Pincus H A. An exploratory analysis of behavioral health care use within families. Psychiatr Serv 2002 Jun;53(6):743–748.
Lin C J, Lave J R. Utilization under children’s health insurance programs: children with vs. without chronic conditions. J Health Soc Policy 2000;11(4):1–14.
Lim FS, Toh MP, et al (2002) “A preliminary evaluation of a disease management programme for patients with diabetes mellitus and hypertension in a primary healthcare setting.” Ann Acad Med Singapore 31(4):431–439.
Liu S I, Prince M, Blizard B, Mann A. The prevalence of psychiatric morbidity and its associated factors in general health care in Taiwan. Psychol Med 2002 May;32(4):629–637.
Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries 1970–1998. Health Serv Res 2003 Jun;38(3):831–865.
Maingay S, Jenkins R, McCulloch A, Friedli L, Parker C. The global response to mental illness— An enormous health burden is increasingly being recognized. BMJ Volume 325 21 September 2002.
Mathet F, Martin-Guehl C, Maurice-Tison S, Bouvard MP. Prevalence of depressive disorders in children and adolescents attending primary care. A survey with the Aquitaine Sentinelle Network. Encephale 2003 Oct;29(5):391–400.
Mattsson S, Stenberg A, Hellstrom AL, Lilja B. The pediatrician’s approach to bed-wetting. A survey shows the hospital clinics adhere to current recommendations. Lakartidningen 2003 Jun 26;100(26–27):2300–2302.
McCleary L, Ridley T. Parenting adolescents with ADHD: evaluation of a psycho education group. Patient Education and Counseling 38(1999):3–10.
Mechanic D. Emerging issues in international mental health services research. Pscyhiatr Serv 1996 Feb;47(4):371–5.
Miranda J, Hohmann A, Attkisson C, Larson D. Impact of Mental Health Status on Use of Health Services. Mental Disorders in Primary Care ©1994.
The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 1999 Dec;56(12):1073–1086.
Murthy RS. Rural Psychiatry in Developing Countries. Psychiatr Serv 49:967–969, July 1998.
Murthy RS. Integration of mental health care into primary care. Demonstration cost-outcome study in India and Pakistan. Br J Psychiatry 2000 June;176:581–588.
The National Academies Press. Institute of Medicine. The Value of Primary Care. Primary Care: America’s Health in a New Era (1996) pp. 52–75.
Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus H A. National trends in the outpatient treatment of depression. JAMA 2002 Jan 9;287(2):203–209.
Olfson M, Marcus SC, Weissman MM, Jensen PS. National trends in the use of psychotropic medications by children. J Am Acad Child Adolesc Psychiatry 2002 May;41(5): 514–521.
Olson AL, Kelleher KJ, Kemper KJ, Zuckerman BS, Hammond CS, Dietrich AJ. Primary care pediatrician’s roles and perceived responsibilities in the management of depression in children and adolescents. Ambulatory Pediatrics 2001;1:91–92.
Ortega AN, Huertas SE, Canino G, Ramirez R, Rubio-Stipec M. Childhood asthma, chronic illness, and psychiatric disorders. J Nerv Ment Dis 2002 May;190(5):275–281.
Patel V, Pereira J, Coutinho L, Fernandes R, Fernandes J, Mann A. Poverty, psychological disorder and disability in primary care attenders in Goa, India. Br J Psychiatry 1998 Jun;172:533–536.
bibliography.htm 12-1-03
Pothen M, Kuruvilla A, Philip K, Joseph A, Jacob KS. Common mental disorders among primary care attenders in Vellore, South India: nature, prevalence and risk factors. Int J Soc Psychiatry 2003 Jun;49(2):119–125.
Real Perez M, Rodriguez-Arias Palomo JL, Cagigas Viadero J, Aparicion Sanz MM, Real Perez MA. Brief family therapy: an option for the treatment of somatoform disorders in primary care. Aten Primaria. 1996 Mar 15:17(4):241–246.
Regier DA, Burke JD, Jr, et al (1982) Proposed classification of health problems. Psychosocial factor affecting health. (eds. Lipkin M, Kupka K) New York, Praeger: 153–184.
Rix S, Paykel ES, Lelliott P, Tylee A, Freeling P, Gask L, Hart D. Impact of a national campaign on GP education: an evaluation of the Defeat Depression Campaign. Br J Gen Pract 1999 Feb;49(439):91–92.
Robinson P, Katin W, Von Korff M, Bush T, Simon G, Lin E, Walker E. The Education of Depressed Primary Care Patients: What Do Patients Think of Interactive Booklets and a Video? The Journal of Family Practice, Vol. 44, No. 6 (June) 1997.
Roeloffs C, Sherbourne C, Unutzer J, Fink A, Tang L, Wells KB. Stigma and depression among primary care patients. Hosp Psychiatry. 2003 Sept–Oct;25(5):311–315.
Rothman A, Wagner E (2003) “Chronic illness management: what is the role of primary care?” Annals of Internal Medicine 138(3):256–261.
Rowan MS, Lawson B, MacLean C, Burge F. Upholding the principles of primary care in preceptors’ practices. Fam Med 2002 Nov–Dec;34(10):744–749.
Rushton J, Bruckman D, Kelleher K. Primary care referral of children with psychosocial problems. Arch Pediatr Adolesc Med 2002 Jun;156(6):592–598.
Sanders M R. Triple P-Positive Parenting Program: towards and empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev 1999 Jun;2(2):71–90.
Sanders M R, Montgomery D T, Brechman-Toussaint M L. The mass media and the prevention of child behavior problems: the evaluation of a television series to promote positive outcomes for parents and their children. J Child Psychol Psychiatry 2000 Oct;41(7):939–948.
Sanders MR, Tully LA, Turner KM, Maher C, McAuliffe C. Training GPs in parent consultation skills. An evaluation of training for the Triple P-Positive Parenting Program. Aust Fam Physician 2003 Sep;32(9):763–768.
Schirm E, Tobi H, Zito JM, de Jong-van den Berg LT. Psychotropic medication in children: a study from the Netherlands. Pediatrics 2001 Aug;108(2):E25.
Schoenbaum M., Kelleher K, et al (in Press April 2004) “Exploratory Evidence on the Market for Effective Depression Care in Pittsburgh”. Psychiatr Serv
Sharp L, Pantell RH, et al (1992) “Psychosocial problems during child health supervision visits: eliciting, then what?” Pediatrics 89(4):619–623.
Shi L, Starfield B, Kennedy B, Kawachi I. Income inequality, primary care, and health indicators. J Fam Pract 1999 Apr;48(4):275–284.
Simon G, VonKorff M, et al (2000) “Randomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care.” BMJ 320(7234):550–554.
Sorensen JL, Hargreaves WA, Friedlander S. Child global rating scales: selecting a measure of client functioning in a large mental health system. Eval Program Plann 1982;5(4):337–347. http://www.ncbi.nlm.nih.gov
Spitzer RL, Williams J B, et al (2000) “Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study.” Am J Obstet Gynecol 183(3):759–769.
Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy. 2002 Jun;60(3):201–218.
Todd C, Patel V, Simunyu E, Gwanzura F, Acuda W, Winston M, Mann A. The onset of common mental disorders in primary care attenders in Harare, Zimbabwe. Psychol Med 1999 Jan:29(1):97–104.
Valenstein M, Vijan S, Zeber JE, Boehm K, Buttar A. The costutility of screening for depression in primary care. Ann Intern Med 2001 Mar 6;134(5):345–360.
Vanstraelen M, Cottrell D. Child and adolescent mental health services: purchasers’ knowledge and plans. BMJ 1994 Jul 23;309(6949):259–261.
Vila G, Nollet-Clemencon C, Vera M, Robert J J, de Blic J, Jouvent R, Mouren-Simeoni MC, Scheinmann P. Prevalence of DSM-IV disorders in children and adolescents with asthma versus diabetes. Can J Psychiatry. 1999 Aug;44(6):562–569.
Walders N, Childs GE, et al (2003) “Barriers to mental health referral from pediatric primary care settings.” Am J Manag Care 9(10):677–683.
Wasserman RC, Kelleher KJ, Bocian A, Baker A, Childs G E, Indacochea F, Stulp C, Gardner WP. Identification of attentional and hyperactivity problems in primary care: a report from pediatric research in office settings and the ambulatory sentinel practice network. Pediatrics 1999 Mar;103(3):E38.
Wren FJ, Scholle SH, Heo J, Comer DM. Pediatric mood and anxiety syndromes in primary care: who gets identified? Int J Psychiatry Med 2003;33(1):1–16.
Zito JM, Safer DJ, dosReis S, Gardner JF, Boles M, Lynch F. Trends in the prescribing of psychotropic medications to preschoolers. JAMA 2000 Feb 23;283(8):1025–1030.
Zito J M, Safer DJ, DosReis S, Gardner J F, Soeken K, Boles M, Lynch F. Rising prevalence of antidepressants among US youths. Pediatrics 2002 May;109(5):721–727.
Zito J M, Safer DJ, DosReis S, Gardner J F, Magder L, Soeken K, Boles M, Lynch F, Riddle MA. Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med 2003 Jan;157(1):17–25.
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Kelleher, K. (2004). Prevention and Intervention in Primary Care. In: Remschmidt, H., Belfer, M.L., Goodyer, I. (eds) Facilitating Pathways. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18611-0_23
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