Physicians' recognition of psychiatric disorders in children and adolescents
G. Chang, V. Warner and M. M. Weissman
Veterans Administration Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, Conn 06510-8025.
We examined the ability of physicians to recognize psychiatric and
behavioral problems in the children and adolescents under their care. The
report by 35 physicians of psychopathology in their patients was compared
with the reports of parents and of children which were derived from direct
and independent assessments of the children and of parents about their
children. Physicians' reports of psychological problems were also compared
with reports by a child psychiatrist who used all available data on the
children and made a best estimate diagnosis. Agreement between the
physicians and any of the three other sources of information--parents,
children, or child psychiatrist--was poor, with kappa ranging from -15 to
.11. Physicians tended to underreport both minor and serious psychiatric
problems in children. These results are discussed in the context of the
recent American Medical Association initiative to improve the health of
children and adolescents.
