The Pediatric Primary-Specialty Care Interface

Forrest, Christopher B.; Glade, Gordon B.; Baker, Alison; Bocian, Alison B.; Kang, Myungsa; Starfield, Bárbara

doi:10.1001/archpedi.153.7.705

Cited by 135 publications

(31 citation statements)

References 18 publications

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“…To date, most studies examining pediatric somatic samples have lacked a control group (23) or have included control groups of healthy patients identified from routine visits (21). However, medical help-seeking is associated with psychological characteristics of parents (28) and children (29) and specialist referral is influenced by parent requests (30). As such, earlier findings of increased psychiatric disorders may not reflect a specific association with the somatic presentation.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders in Youth with Medically Unexplained Chest Pain versus Innocent Heart Murmur

Lipsitz

Hsu

Apfel

et al. 2012

The Journal of Pediatrics

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Objective To examine prevalence of DSM-IV psychiatric disorders in youth with chest pain compared with a control sample with innocent heart murmur. Study design We assessed youth ages 8–17 years who were evaluated in cardiology settings for medically unexplained chest pain (N=100) or innocent heart murmur (N=80). We conducted semi-structured interviews and assessed medical history, quality of life, and disability. Results Youth with chest pain had a higher prevalence of psychiatric disorders compared with those with murmur (74% vs. 47%, X2 = 13.3; p<.001). Anxiety disorders predominated, although major depression was also more common in the chest pain group (9% vs. 0%; FET; p<.01). Onset of psychiatric disorders generally preceded chest pain. Patterns were similar for boys and girls and for children and adolescents. Chest pain was associated with poorer quality of life and with pain-related disability for youth with comorbid psychiatric disorder. Conclusions In childhood and adolescence, medically unexplained chest pain is associated with a high prevalence of psychiatric disorders. Systematic mental health screening may improve detection and enhance management of these patients.

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Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders in Youth with Medically Unexplained Chest Pain versus Innocent Heart Murmur

Lipsitz

Hsu

Apfel

et al. 2012

The Journal of Pediatrics

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“…A pediatrician often provides ongoing care of the pre-school child, and this role gradually diminishes over time upon school entry (Forrest et al, 1999). From this point onward, especially in the vulnerable population that includes children with special needs, the school psychologist and other professionals in the school setting play a primary role.…”

Section: Barriers To Collaborationmentioning

confidence: 99%

Improving Outcomes for Children With Developmental Disabilities Through Enhanced Communication and Collaboration Between School Psychologists and Physicians

Ritzema

Sladeczek

Ghosh

et al. 2014

Canadian Journal of School Psychology

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A renewed call for enhanced communication and collaboration between school psychology and medicine is envisioned, in light of a transdisciplinary model, where school psychologists, family physicians, and other health professionals transcend disciplinary boundaries. Recommendations for optimal communication and collaboration are described, as well as challenges inherent in such an endeavor. School psychologist-physician collaboration has the potential to result in significant improvements in outcomes for families and children with developmental disabilities. A case illustration highlights the major points mirrored in the discussion, and conclusions are drawn regarding necessary components for meaningful change to occur. RésuméUne hausse de communication et de collaboration entre la psychologie scolaire et la médecine est envisagée en vue d'un modèle transdisciplinaire. Ce modèle a pour but d'assembler des psychologues scolaires, des médecins de famille et autres professionnels de la santé et de dépasser les limites de leurs disciplines. Les défis reliés à une telle collaboration ainsi que des recommandations pour améliorer la communication entre professionnels sont décrits. Des collaborations entre psychologues scolaires et médecins ont le potentiel d'améliorer les issues des enfants et des familles atteints de troubles de développement. Une étude de cas est présentée qui reflète les conclusions majeures dans la discussion, de plus des conclusions sont tirées pour assurer un changement durable.

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“…Illnesses of this nature include Prader-Willi Syndrome, Down Syndrome, Laurence-Moon Syndrome, excess production of cortisol (Cushing's syndrome), thalamic or pituitary disorders, hypothyroidism, type 1 and 2 diabetes, obstructed sleep apnea, depression, anxiety, obsessive-compulsive disorders, attentiondeficit/hyperactivity disorders, asthma/reactive airway disease, pregnancy, and neuromuscular, musculoskeletal or cardiovascular disorders (Forrest, et al, 1999;Legler & Rose, 1998;McCance & Huether, 2002).…”

Section: Chronic Medical Conditionsmentioning

confidence: 99%

“…Individuals were seen and treated by a HCP regarding the course of action to resolve the health problem (Forrest, et al, 1999;Healthy People 2010, 2000.…”

Section: Outpatient Primary Care Clinicmentioning

confidence: 99%

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A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

Quirke¹

2004

PsycEXTRA Dataset

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and A descriptive study of the incidence of missed opportunities in identifying, managing and referring children and adolescents at-risk of overweight and overweight were conducted using a retrospective chart review of two Midwest, suburban, private outpatient primary care clinics. Of the 208 medical records reviewed, the incidence of atrisk of overweight (BMI-for-age < 85% < 95%) in children and adolescents was 8.8%and 9.4%, respectively. The overweight (BMI-for-age > 95%) prevalence rate for each group was 14.7% and 17.9%, respectively. None of the 19 children or adolescents with a calculated BMI-for-age as at-risk for overweight was identified by the HCP with an ICD 9-CM code for obesity or abnormal weight gain in the medical record. Of the 34 subjects with a calculated BMI-for-age as overweight, 40% of children (n = 6) and 42% of adolescents (n = 8) were identified by the HCP as overweight as evidenced by a diagnosis of obesity or abnormal weight in the medical record.None of the children or adolescents at-risk of overweight received a referral for nutrition or psychological counseling or specialty care. Twenty-three of the 53 children and adolescents identified as being at-risk of overweight or overweight also had a chronic medical condition. Of these 23, only two children with Reactive Airway Disease were given referrals to nutritional medicine.

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The Pediatric Primary-Specialty Care Interface

Cited by 135 publications

References 18 publications

Psychiatric Disorders in Youth with Medically Unexplained Chest Pain versus Innocent Heart Murmur

Psychiatric Disorders in Youth with Medically Unexplained Chest Pain versus Innocent Heart Murmur

Improving Outcomes for Children With Developmental Disabilities Through Enhanced Communication and Collaboration Between School Psychologists and Physicians

A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

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