TY - JOUR
KW - Behavior Therapy
KW - Behavioral Symptoms/diagnosis/therapy
KW - Bipolar Disorder/diagnosis/therapy
KW - Child
KW - Child Behavior
KW - Child Health Services/statistics & numerical data
KW - Education, Nonprofessional
KW - Female
KW - Humans
KW - Irritable Mood
KW - Male
KW - Mental Disorders/diagnosis/therapy
KW - Mental Health Services/statistics & numerical data
KW - Primary Health Care/statistics & numerical data
KW - Psychotropic Drugs
KW - Qualitative Research
KW - Referral and Consultation/statistics & numerical data
KW - Bipolar
KW - Child and adolescent psychiatry
KW - irritability
KW - primary care
KW - school-aged children
AU - U. Hameed
AU - C. Dellasega
AU - A. Scandinaro
A1 - 
AB - BACKGROUND: Irritability, a common behavioral problem for school-aged children, is often first assessed by primary care providers, who manage about a third of mental health conditions in children. Until recent changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM), irritability was often associated with mood disorders, which may have led to increases in bipolar disorder diagnosis and prescription of mood stabilizing medication. OBJECTIVE: Our aim was to explore differences between the approaches psychiatric and primary care providers use to assess irritability. METHODS: A single trained interviewer conducted detailed interviews and collected demographic data from a homogeneous group of physicians that saturated with a sample size of 17 pediatric, family medicine, and psychiatric providers who evaluate and treat school-aged children. Qualitative and quantitative data were collected and analyzed. RESULTS: In general, primary care providers chose to refer children with irritability to mental health specialists when medication management became complex, while the psychiatric providers chose behavior modification and parent education strategies rather than medications. The psychiatric group had a significantly higher caseload mix, prior experience with irritability, and more confidence in their assessment capabilities. There was lack of continuing medical education about irritability in all groups. CONCLUSION: This preliminary study highlights the importance of collaboration between primary care and subspecialties to promote accurate assessment and subsequent treatment of school-aged children with irritability, who can represent a safety concern for self and others. More research is needed to establish an efficient method of assessing and managing irritability in primary care and better utilization of specialists.
AD - Child and Adolescent Psychiatry, Penn State College of Medicine, USA.; Department of Humanities, Penn State College of Medicine, USA.; Departments of Psychiatry and Humanities, Penn State College of Medicine, USA.
BT - Clinical child psychology and psychiatry
C5 - Education & Workforce; Healthcare Disparities
CP - 2
CY - England
DO - 10.1177/1359104519865591
IS - 2
JF - Clinical child psychology and psychiatry
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Irritability, a common behavioral problem for school-aged children, is often first assessed by primary care providers, who manage about a third of mental health conditions in children. Until recent changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM), irritability was often associated with mood disorders, which may have led to increases in bipolar disorder diagnosis and prescription of mood stabilizing medication. OBJECTIVE: Our aim was to explore differences between the approaches psychiatric and primary care providers use to assess irritability. METHODS: A single trained interviewer conducted detailed interviews and collected demographic data from a homogeneous group of physicians that saturated with a sample size of 17 pediatric, family medicine, and psychiatric providers who evaluate and treat school-aged children. Qualitative and quantitative data were collected and analyzed. RESULTS: In general, primary care providers chose to refer children with irritability to mental health specialists when medication management became complex, while the psychiatric providers chose behavior modification and parent education strategies rather than medications. The psychiatric group had a significantly higher caseload mix, prior experience with irritability, and more confidence in their assessment capabilities. There was lack of continuing medical education about irritability in all groups. CONCLUSION: This preliminary study highlights the importance of collaboration between primary care and subspecialties to promote accurate assessment and subsequent treatment of school-aged children with irritability, who can represent a safety concern for self and others. More research is needed to establish an efficient method of assessing and managing irritability in primary care and better utilization of specialists.
PP - England
PY - 2020
SN - 1461-7021; 1359-1045
SP - 333
EP - 345
EP - 
T1 - Assessment of irritability in school-aged children by pediatric, family practice, and psychiatric providers
T2 - Clinical child psychology and psychiatry
TI - Assessment of irritability in school-aged children by pediatric, family practice, and psychiatric providers
U1 - Education & Workforce; Healthcare Disparities
U2 - 31353938
U3 - 10.1177/1359104519865591
VL - 25
VO - 1461-7021; 1359-1045
Y1 - 2020
Y2 - Apr
ER -