Mental health in pediatric settings: distribution of disorders and factors related to service use

J Am Acad Child Adolesc Psychiatry. 2000 Jul;39(7):841-9. doi: 10.1097/00004583-200007000-00012.


Objectives: To examine child psychiatric disorders in pediatric settings and identify factors associated with parents' use of pediatricians as resources concerning emotional/behavioral issues and use of mental health services.

Method: The sample consists of 5- to 9-year-olds (mean = 7.17 years, SD = 1.41) from a representative sample (N = 1,060) of pediatric practices. Parent interviews included assessments of psychiatric disorders with the Diagnostic Interview Schedule for Children (DISC-R), parental depression/anxiety, possible child abuse, stress, support, and the use of mental health services.

Results: The prevalence of any DISC disorder was 16.8%. Parental depression/anxiety and possible child abuse were associated independently with 2- to 3-times higher rates of disorder. Many parents (55%) who reported any disorder did not report discussing behavioral/emotional concerns with their pediatrician. Factors associated with discussing behavioral/emotional issues were the presence of any disorder and financial stress. Factors related to seeing a mental health professional were discussing behavioral/emotional issues with the pediatrician, single parenthood, and stressful life events.

Conclusions: The prevalence rates of disorders in this setting suggest that pediatricians are well-placed to identify and refer children with psychiatric disorders. However, most parents do not discuss behavioral/emotional issues with their pediatrician. Methods for improving rates of identification and referral (e.g., routine screening) are considered.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Child Health Services / statistics & numerical data*
  • Child, Preschool
  • Community Mental Health Services / statistics & numerical data*
  • Connecticut / epidemiology
  • Follow-Up Studies
  • Humans
  • Interview, Psychological
  • Logistic Models
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Health
  • Parents / psychology*
  • Pediatrics / statistics & numerical data*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Referral and Consultation
  • Risk Factors
  • Sampling Studies
  • Socioeconomic Factors