TY - JOUR
KW - Adolescent
KW - Anxiety Disorders/diagnosis/epidemiology
KW - Asthma/epidemiology
KW - Child
KW - Child Health Services/organization & administration
KW - Comorbidity
KW - Depressive Disorder/diagnosis/epidemiology
KW - Female
KW - Health Services Accessibility/organization & administration
KW - Humans
KW - Male
KW - Medical Assistance/organization & administration
KW - Medical Records Systems, Computerized
KW - Mental Health Services/organization & administration
KW - Primary Health Care/organization & administration
KW - Quality of Health Care
KW - Severity of Illness Index
KW - Socioeconomic Factors
AU - W. J. Katon
AU - L. Richardson
AU - J. Russo
AU - P. Lozano
AU - E. McCauley
A1 - 
AB - OBJECTIVES: Youth with asthma have a high rate of anxiety and depressive disorders, and these comorbid disorders are associated with increased asthma symptom burden and functional impairment. This study examined the rates and predictors of recognition of anxiety and depressive disorders among youth (ages 11 to 17) with asthma who are seen in primary care settings as well as the quality of mental health care provided to those with comorbid anxiety and depression over a 12-month period. METHODS: This study used automated utilization and pharmacy data from a health maintenance organization to describe the rate of recognition of Diagnostic and Statistical Manual of Mental Disorders, edition IV, anxiety and depressive disorders and the quality of mental health care provided for the 17% of youth with asthma and comorbid anxiety and/or depression during the 12-month period prior to diagnosis. Psychiatric diagnoses were based on a telephone version of the Computerized Diagnostic Interview Schedule for Children (Version 4.0). RESULTS: Approximately 35% of youth with 1 or more anxiety and depressive disorders and 43% of those with major depression were recognized by the medical system during a 12-month period. Greater functional impairment (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.25-8.79), higher severity on parent-rated anxiety and depressive symptoms (OR 2.49, 95% CI 1.04-6.00), and a greater number of primary care visits (OR 1.26, 95% CI 1.10-1.44) were associated with significantly higher recognition rates while having Medicaid or Washington state medical insurance was associated with lower rates of recognition (OR 0.27, 95% CI 0.08-0.92). Only approximately 1 in 5 youths with comorbid major depression received an adequate dosage and duration of antidepressant medication, and only 1 in 6 received a minimally adequate number of psychotherapy sessions (> or =4 visits). CONCLUSION: Rates of recognition of comorbid anxiety and depressive disorders are low in youth with asthma and few youth with asthma and comorbid anxiety and depression receive guideline-level mental health treatment.
BT - Medical care
C5 - HIT & Telehealth
CP - 12
CY - United States
DO - 10.1097/01.mlr.0000237421.17555.8f
IS - 12
JF - Medical care
N2 - OBJECTIVES: Youth with asthma have a high rate of anxiety and depressive disorders, and these comorbid disorders are associated with increased asthma symptom burden and functional impairment. This study examined the rates and predictors of recognition of anxiety and depressive disorders among youth (ages 11 to 17) with asthma who are seen in primary care settings as well as the quality of mental health care provided to those with comorbid anxiety and depression over a 12-month period. METHODS: This study used automated utilization and pharmacy data from a health maintenance organization to describe the rate of recognition of Diagnostic and Statistical Manual of Mental Disorders, edition IV, anxiety and depressive disorders and the quality of mental health care provided for the 17% of youth with asthma and comorbid anxiety and/or depression during the 12-month period prior to diagnosis. Psychiatric diagnoses were based on a telephone version of the Computerized Diagnostic Interview Schedule for Children (Version 4.0). RESULTS: Approximately 35% of youth with 1 or more anxiety and depressive disorders and 43% of those with major depression were recognized by the medical system during a 12-month period. Greater functional impairment (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.25-8.79), higher severity on parent-rated anxiety and depressive symptoms (OR 2.49, 95% CI 1.04-6.00), and a greater number of primary care visits (OR 1.26, 95% CI 1.10-1.44) were associated with significantly higher recognition rates while having Medicaid or Washington state medical insurance was associated with lower rates of recognition (OR 0.27, 95% CI 0.08-0.92). Only approximately 1 in 5 youths with comorbid major depression received an adequate dosage and duration of antidepressant medication, and only 1 in 6 received a minimally adequate number of psychotherapy sessions (> or =4 visits). CONCLUSION: Rates of recognition of comorbid anxiety and depressive disorders are low in youth with asthma and few youth with asthma and comorbid anxiety and depression receive guideline-level mental health treatment.
PP - United States
PY - 2006
SN - 0025-7079; 0025-7079
SP - 1064
EP - 1072
EP - 
T1 - Quality of mental health care for youth with asthma and comorbid anxiety and depression
T2 - Medical care
TI - Quality of mental health care for youth with asthma and comorbid anxiety and depression
U1 - HIT & Telehealth
U2 - 17122709
U3 - 10.1097/01.mlr.0000237421.17555.8f
VL - 44
VO - 0025-7079; 0025-7079
Y1 - 2006
ER -