Sushila Russell, Balakrishnan Subramanian, Paul Swamidhas Sudhakar Russell
{"title":"青少年健康诊所就诊患者的心理病理学和功能障碍:对医疗模式改革的启示。","authors":"Sushila Russell, Balakrishnan Subramanian, Paul Swamidhas Sudhakar Russell","doi":"10.1186/1750-4732-2-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In developing countries, primary health care facilities, such as adolescent health clinics, are frequently the first contact for an adolescent with a health professional for a myriad of health problems including mental health issues. Psychopathology is prevalent among adolescents, and causes significant educational, occupational and social impairment. The presence of psychopathology with impairment requires the development of treatment models to address both of these components. We studied the psychopathology and associated impairment in patients at an adolescent health clinic as an indicator for healthcare model reform.</p><p><strong>Methods: </strong>Psychopathology and functional impairment were assessed in 100 patients at an adolescent health clinic in the city of Chennai, Southern India. The patients had initially visited the clinic for various medical disorders. Adolescents were diagnostically classified for psychopathology using the Child Behaviour Checklist (CBCL) and the International Classification of Disease: 10th Edition (ICD-10). Functional impairment was assessed with the Child Global Assessment Scale (CGAS). Data were analysed using bivariate and multivariate methods.</p><p><strong>Results: </strong>Eight percent had a diagnosable psychopathology, and they also satisfied at least one ICD-10 diagnosis. Adolescents screened had significant impairment as indicated by low CGAS scores, whether or not they presented with psychopathology. Adolescents with psychopathology were more functionally impaired both in the bivariate (Z = -3.1; P = 0.002) and multivariate analyses (beta(SE) = 1.09(0.3), t = 3.9, 95% confidence interval = 0.5, 1.6; P = 0.001). Impairment in adolescents without psychopathology is primarily attributed to the medical disorders they presented with.</p><p><strong>Conclusion: </strong>Patients attending adolescent health clinics should be screened for psychopathology and functional impairment. Documented psychopathology and impairment necessitates the use of a combined treatment model to address the short and long-term problems these adolescents face.</p>","PeriodicalId":87450,"journal":{"name":"Osteopathic medicine and primary care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2008-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2259363/pdf/","citationCount":"0","resultStr":"{\"title\":\"Psychopathology and functional impairment among patients attending an adolescent health clinic: Implications for healthcare model reform.\",\"authors\":\"Sushila Russell, Balakrishnan Subramanian, Paul Swamidhas Sudhakar Russell\",\"doi\":\"10.1186/1750-4732-2-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In developing countries, primary health care facilities, such as adolescent health clinics, are frequently the first contact for an adolescent with a health professional for a myriad of health problems including mental health issues. Psychopathology is prevalent among adolescents, and causes significant educational, occupational and social impairment. The presence of psychopathology with impairment requires the development of treatment models to address both of these components. We studied the psychopathology and associated impairment in patients at an adolescent health clinic as an indicator for healthcare model reform.</p><p><strong>Methods: </strong>Psychopathology and functional impairment were assessed in 100 patients at an adolescent health clinic in the city of Chennai, Southern India. The patients had initially visited the clinic for various medical disorders. Adolescents were diagnostically classified for psychopathology using the Child Behaviour Checklist (CBCL) and the International Classification of Disease: 10th Edition (ICD-10). Functional impairment was assessed with the Child Global Assessment Scale (CGAS). Data were analysed using bivariate and multivariate methods.</p><p><strong>Results: </strong>Eight percent had a diagnosable psychopathology, and they also satisfied at least one ICD-10 diagnosis. Adolescents screened had significant impairment as indicated by low CGAS scores, whether or not they presented with psychopathology. Adolescents with psychopathology were more functionally impaired both in the bivariate (Z = -3.1; P = 0.002) and multivariate analyses (beta(SE) = 1.09(0.3), t = 3.9, 95% confidence interval = 0.5, 1.6; P = 0.001). Impairment in adolescents without psychopathology is primarily attributed to the medical disorders they presented with.</p><p><strong>Conclusion: </strong>Patients attending adolescent health clinics should be screened for psychopathology and functional impairment. Documented psychopathology and impairment necessitates the use of a combined treatment model to address the short and long-term problems these adolescents face.</p>\",\"PeriodicalId\":87450,\"journal\":{\"name\":\"Osteopathic medicine and primary care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2008-02-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2259363/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Osteopathic medicine and primary care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/1750-4732-2-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteopathic medicine and primary care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/1750-4732-2-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Psychopathology and functional impairment among patients attending an adolescent health clinic: Implications for healthcare model reform.
Background: In developing countries, primary health care facilities, such as adolescent health clinics, are frequently the first contact for an adolescent with a health professional for a myriad of health problems including mental health issues. Psychopathology is prevalent among adolescents, and causes significant educational, occupational and social impairment. The presence of psychopathology with impairment requires the development of treatment models to address both of these components. We studied the psychopathology and associated impairment in patients at an adolescent health clinic as an indicator for healthcare model reform.
Methods: Psychopathology and functional impairment were assessed in 100 patients at an adolescent health clinic in the city of Chennai, Southern India. The patients had initially visited the clinic for various medical disorders. Adolescents were diagnostically classified for psychopathology using the Child Behaviour Checklist (CBCL) and the International Classification of Disease: 10th Edition (ICD-10). Functional impairment was assessed with the Child Global Assessment Scale (CGAS). Data were analysed using bivariate and multivariate methods.
Results: Eight percent had a diagnosable psychopathology, and they also satisfied at least one ICD-10 diagnosis. Adolescents screened had significant impairment as indicated by low CGAS scores, whether or not they presented with psychopathology. Adolescents with psychopathology were more functionally impaired both in the bivariate (Z = -3.1; P = 0.002) and multivariate analyses (beta(SE) = 1.09(0.3), t = 3.9, 95% confidence interval = 0.5, 1.6; P = 0.001). Impairment in adolescents without psychopathology is primarily attributed to the medical disorders they presented with.
Conclusion: Patients attending adolescent health clinics should be screened for psychopathology and functional impairment. Documented psychopathology and impairment necessitates the use of a combined treatment model to address the short and long-term problems these adolescents face.