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Chen V, Bellodi Schmidt F. Provider perceptions and practices for appearance-related psychosocial distress caused by dermatologic disease in children. Pediatr Dermatol 2021; 38:1074-1079. [PMID: 34369607 DOI: 10.1111/pde.14679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Differences in appearance are often stigmatized in society, and dermatologic disease can lead to psychological and social sequelae that significantly impact patient quality of life. However, discrepancy between patient-reported and physician-assessed psychological distress raises a question of how clinicians are prepared in recognizing and managing the psychosocial impact of a child's skin condition. We aim to identify current practices among healthcare providers toward properly addressing appearance-related psychosocial distress in pediatric dermatology patients. METHODS Surveys assessing provider attitude and practices to appearance-related distress were distributed to members of the Society of Pediatric Dermatology via the Pediatric Dermatology Research Alliance, and Florida Chapter of American Academy of Pediatrics. RESULTS Over half of respondents report encountering appearance-related psychosocial distress on a daily basis and believe screening to be important. However, only 14% use a validated screening tool and 18% screen all patients. Major obstacles to generalized screening were limited time and staffing. Self-reported knowledge and management of appearance-related psychosocial distress includes direct counseling and referrals to local support groups, mental health providers, specialized summer camps, and school-affiliated resources. Nevertheless, 86% expressed interest in learning more about appearance-related psychosocial distress, particularly about patient education and resources. CONCLUSIONS Although clinicians frequently encounter appearance-related distress with pediatric dermatology patients, screening is selective and lacks standardization. Self-reported knowledge and management is comprehensive, but there is a need for increased training in patient education and resources.
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Affiliation(s)
- Vivien Chen
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Fernanda Bellodi Schmidt
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Hussong AM, Midgette AJ, Thomas TE, Coffman JL, Cho S. Coping and Mental Health in Early Adolescence during COVID-19. Res Child Adolesc Psychopathol 2021; 49:1113-1123. [PMID: 33856611 PMCID: PMC8048334 DOI: 10.1007/s10802-021-00821-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 11/28/2022]
Abstract
The current longitudinal study examines changes in overall mental health symptomatology from before to after the COVID-19 outbreak in youth from the southeastern United States as well as the potential mitigating effects of self-efficacy, optimism, and coping. A sample of 105 parent-child dyads participated in the study (49% boys; 81% European American, 1% Alaska Native/American Indian, 9% Asian/Asian American; 4% Black/African American; 4% Latinx; and 4% other; 87% mothers; 25% high school graduate without college education; 30% degree from 4-year college; 45% graduate or professional school). Parents completed surveys when children were aged 6-9, 8-12, 9-13, and 12-16, with the last assessments occurring between May 13, 2020 and July 1, 2020 during the COVID-19 outbreak. Children also completed online surveys at ages 11-16 assessing self-efficacy, optimism, and coping. Multi-level modeling analyses showed a within-person increase in mental health symptoms from before to after the outbreak after controlling for changes associated with maturation. Symptom increases were mitigated in youth with greater self-efficacy and (to some extent) problem-focused engaged coping, and exacerbated in youth with greater emotion-focused engaged and disengaged coping. Implications of this work include the importance of reinforcing self-efficacy in youth during times of crisis, such as the pandemic, and the potential downsides of emotion-focused coping as an early response to the crisis for youth.
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Affiliation(s)
- Andrea M Hussong
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.
| | - Allegra J Midgette
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Taylor E Thomas
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer L Coffman
- Department of Human Development and Family Studies, University of North Carolina At Greensboro, Greensboro, NC, USA
| | - Su Cho
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
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Andrade G, Castelo-Soccio L. How to recognize and approach psychiatric and psychosocial impairments in the pediatric dermatology patient with a primary dermatologic disease. Pediatr Dermatol 2019; 36:759-763. [PMID: 31298424 DOI: 10.1111/pde.13891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Significant psychiatric and psychosocial comorbidity in the pediatric dermatology patient was observed. This paper gives a realistic approach on how to approach these issues in the typical pediatric dermatology clinic. It will outline how to implement a validated screening process, how to discuss these issues with patients, and when and how to make an appropriate mental health referral.
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Affiliation(s)
- Gabriela Andrade
- Division of Pediatrics, Section of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, The University of Pennsylvania Perlman School of Medicine, Philadelphia, Pennsylvania
| | - Leslie Castelo-Soccio
- Division of Pediatrics, Section of Dermatology, The Children's Hospital of Philadelphia, The University of Pennsylvania Perlman School of Medicine, Philadelphia, Pennsylvania
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Gutiérrez-Colina AM, Lee JL, Reed-Knight B, Hayutin L, Lewis JD, Blount RL. The Pediatric Symptom Checklist: Comparison of symptom profiles using three factor structures between pediatric gastroenterology and general pediatric patients. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1163493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Jennifer L. Lee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Bonney Reed-Knight
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
- GI Care for Kids, Atlanta, GA
| | - Lisa Hayutin
- Department of Psychology, University of Georgia, Athens, GA
| | - Jeffery D. Lewis
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
- GI Care for Kids, Atlanta, GA
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Abstract
Various screening questionnaires have been established to identify psychopathology in children and adolescents. Some of these instruments include the pediatric symptom checklist (PSC), the pediatric symptom checklist (CBCL) and reporting questionnaire for children (RQC). However, many of the patients and their families may not speak English, and this can be a barrier to identifying and properly treating monolingual Spanish-speaking patients and families. There is a need for optimal mental health screening in Spanish speaking populations given the continued growth of the United States as a diverse country with complex demographic structure. Because of the diversity within the use of Spanish in Hispanic countries of origin, the aim of this study is to present unified Spanish versions of the RQC and PSC achieved through simultaneously and independently translating them into three versions of Spanish (RQC-SP and PSC-SP). To test the psychiatric validity of RQC-SP and PSC-SP, these both were administered simultaneously along with the Spanish version of the CBCL, which had already been well established. All three of these tools were given to Spanish speaking parents of pediatric outpatients (n = 22) while waiting for their clinic appointments. The RQC-SP had a correlation to the CBCL with R = 0.779 and p < 0.001. The RQC-SP as compared with the CBCL had a false negative of 0/8 (0.00) with a sensitivity of 8/8 = 1.00. The false positives were 2/14 (0.143) and specificity 12/15 (0.85). The PSC-SP correlated with the CBCL with R = 0.897 and p < 0.001. The PSC-SP correlation with the CBCL had false negative of 7/8 (0.875) and sensitivity of 1/8 (0.125) and false positive 0/14 (0.00) and specificity 14/14 (1.00). The RQC-SP and PSC-SP are brief, well-validated, reliable instruments designed.
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Augustin M, Langenbruch AK, Herberger K, Baade K, Goepel L, Blome C. Quality of life measurement in chronic wounds and inflammatory skin diseases: Definitions, standards and instruments. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.wndm.2014.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wolfe-Christensen C, Manolis A, Guy WC, Kovacevic N, Zoubi N, El-Baba M, Kovacevic LG, Lakshmanan Y. Bladder and bowel dysfunction: evidence for multidisciplinary care. J Urol 2013; 190:1864-8. [PMID: 23669566 DOI: 10.1016/j.juro.2013.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2013] [Indexed: 12/27/2022]
Abstract
PURPOSE We examined the symptoms of bladder-bowel dysfunction (ie severity of voiding dysfunction and stool consistency) and psychosocial difficulties in children presenting to the pediatric urology clinic for voiding dysfunction and to the pediatric gastroenterology clinic for functional constipation. MATERIALS AND METHODS Parents of children seen at the gastroenterology clinic were recruited during the outpatient clinic appointment, and parents of children seen at the urology clinic were randomly selected from the research database and matched to the gastroenterology sample based on age and gender of the child. All parents completed the Dysfunctional Voiding Scoring System, Bristol Stool Form Scale, Pediatric Symptom Checklist and Parenting Stress Index™-Short Form, which assessed severity of voiding dysfunction, stool consistency, level of psychosocial difficulties and level of parenting stress, respectively. RESULTS Children seen at the urology and gastroenterology clinics did not differ significantly on any of the measures, indicating that the severity of their bladder-bowel dysfunction is similar. However, they had significantly more severe voiding dysfunction, more constipated stool and more psychosocial difficulties than historical healthy controls. Additionally, level of parenting stress was significantly correlated with patient level of psychosocial difficulties and severity of voiding dysfunction. CONCLUSIONS Patients with bladder and bowel dysfunction represent a homogeneous group that would potentially benefit from a multidisciplinary treatment approach involving urology, gastroenterology and psychology professionals.
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Quality of Life Measures for Dermatology: Definition, Evaluation, and Interpretation. CURRENT DERMATOLOGY REPORTS 2012. [DOI: 10.1007/s13671-012-0020-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kent G. Understanding the experiences of people with disfigurements: An integration of four models of social and psychological functioning. PSYCHOL HEALTH MED 2010; 5:117-129. [DOI: 10.1080/713690187] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fox FE, Rumsey N, Morris M. "Ur skin is the thing that everyone sees and you cant change it!": exploring the appearance-related concerns of young people with psoriasis. Dev Neurorehabil 2007; 10:133-41. [PMID: 17687986 DOI: 10.1080/13638490701217594] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The failure of research to capture the qualitative experiences of young people who have chronic skin conditions means that their psychosocial needs are poorly understood. Using a grounded theory approach, this study facilitated group discussions between adolescents with psoriasis in order to rapidly identify themes about their support needs. METHODS Three online focus groups were hosted in a real time forum. In total, 8 young people aged 11-18 years were recruited through the websites of psoriasis support organizations. Focus groups lasted an average of 1 hour and data was analysed using grounded theory techniques. RESULTS Appearance-related concerns are central to the experiences of young people with psoriasis. Participants constructed their individual struggle (It and Me) in physical, emotional, motivational and intellectual terms. A strong sense of Us developed as participants recognized the value of meeting peers with psoriasis. This enabled groups to blame Them for their negative social experiences. DISCUSSION The findings are discussed in the context of literature around adolescence and appearance. It is suggested that the experience of negative social encounters in adolescence may have long-term implications for appearance anxiety specifically and self-esteem generally. The potential of peer support to improve these outcomes is considered.
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Affiliation(s)
- Fiona E Fox
- Centre for Appearance Research, Faculty of Applied Sciences, University of the West of England, Bristol, UK.
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Dennis H, Rostill H, Reed J, Gill S. Factors promoting psychological adjustment to childhood atopic eczema. J Child Health Care 2006; 10:126-39. [PMID: 16707541 DOI: 10.1177/1367493506062552] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research has found that children with atopic eczema are more likely to experience psychosocial difficulties than would be expected within the general population. This article aims to explore the relationship between child, parent and family factors in promoting positive adjustment to atopic eczema. Children aged five to 11 years with atopic eczema and their parents were identified from a specialist children's dermatology clinic. Seventy-four respondents completed questionnaires assessing child behaviour, parental well-being and family functioning. Parental psychological health, a supportive family environment and low impact of atopic eczema on family functioning were found to predict lower levels of internalizing behaviour (anxiety, depression and social withdrawal). These findings emphasize the importance of family and parental psychological processes rather than biomedical variables in promoting positive adjustment to atopic eczema.
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KENT G, AL-ABADIE M. Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1996.tb00116.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jordan SS, Hilker KA, Stoppelbein L, Elkin TD, Applegate H, Iyer R. Nocturnal enuresis and psychosocial problems in pediatric sickle cell disease and sibling controls. J Dev Behav Pediatr 2005; 26:404-11. [PMID: 16344656 DOI: 10.1097/00004703-200512000-00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To evaluate current and lifetime prevalence rates of nocturnal enuresis and psychosocial problems among children with sickle cell disease (SCD) in comparison with sibling controls, a structured interview and the Pediatric Symptom Checklist were administered to primary caretakers regarding 126 of their children aged 5 to 17 with SCD and 47 sibling controls. Lifetime rates of enuresis among children with SCD were comparable to similar studies, and exceeded population prevalence and sibling control rates. In addition, enuretic children had higher levels of total psychosocial problems on the Pediatric Symptom Checklist regardless of group status, although patterns of subscale differences varied by group and enuresis history after controlling for child age. These findings replicate and extend previous findings and provide further evidence to support a need for monitoring of hydration levels and screening for psychosocial problems among children with SCD and enuresis, as well as evaluation of the psychometric properties of psychosocial screening measures and identification of efficacious treatments for enuresis in children with SCD.
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Affiliation(s)
- Sara Sytsma Jordan
- Department of Psychology, University of Southern Mississippi, Hattiesburg 39406-5025, USA.
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Borowsky IW, Mozayeny S, Ireland M. Brief psychosocial screening at health supervision and acute care visits. Pediatrics 2003; 112:129-33. [PMID: 12837878 DOI: 10.1542/peds.112.1.129] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify factors associated with positive scores on a brief psychosocial screening tool with subscales for internalizing, externalizing, and attention problems. METHODS Parents of 2028 children between the ages of 7 and 15 years seen in a sample of 8 primary care practices in the Minneapolis-St Paul metropolitan area completed a brief questionnaire that included the 17-item Pediatric Symptom Checklist (PSC), demographic information, and the reason for the child's visit to the clinic. RESULTS Overall, 22% of the youth had at least 1 positive PSC-17 subscale or a positive PSC-17 total score. Twelve percent scored positive on the internalizing subscale, 10% on the externalizing subscale, 7% on the attention subscale, and 11% had a positive PSC-17 total score. Although boys were more likely than girls to score positive on the attention and aggression subscales, boys and girls were equally likely to have a positive score on the depression subscale. Children not living with both biological parents and those with a household member receiving public assistance were significantly more likely to show psychosocial dysfunction. Controlling for demographic characteristics, patients presenting for an illness-related or injury visit were more likely to score positive on the screen than those presenting for a routine well-child visit (odds ratio: 1.46; 95% confidence interval: 1.07-1.98). CONCLUSIONS Clinicians will miss opportunities to identify emotional and behavioral disorders among children and adolescents who may be at a higher risk if they limit psychosocial screening to health supervision visits. Further research is needed to identify effective strategies for using primary care for recognizing, diagnosing, and treating mental health disorders in children and adolescents.
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Affiliation(s)
- Iris Wagman Borowsky
- Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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Peñas PF, Jones-Caballero M. Calidad de vida (II). Calidad de vida en Dermatología. ACTAS DERMO-SIFILIOGRAFICAS 2002. [DOI: 10.1016/s0001-7310(02)76619-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- A Y Finlay
- Department of Dermatology, University of Wales College of Medicine, Cardiff, United Kingdom.
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Pagano ME, Cassidy LJ, Little M, Murphy JM, Jellinek MS. IDENTIFYING PSYCHOSOCIAL DYSFUNCTION IN SCHOOL-AGE CHILDREN: THE PEDIATRIC SYMPTOM CHECKLIST AS A SELF-REPORT MEASURE. PSYCHOLOGY IN THE SCHOOLS 2000; 37:91-106. [PMID: 22328794 DOI: 10.1002/(sici)1520-6807(200003)37:2%3c91::aid-pits1%3e3.0.co;2-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The Pediatric Symptom Checklist (PSC) is a brief, well-validated parent-report questionnaire designed to detect psychosocial dysfunction in school-age children during pediatric primary care visits. This study assessed the utility of the PSC when completed by children (PSC-Y) ages 9-14 in a public school when parents are not available (n = 173). The PSC-Y identified 20% of children as having psychosocial problems, a rate similar to other low-income samples. When compared with teacher ratings of attention and behavior problems, the PSC-Y showed a sensitivity of 94% and a specificity of 88%. The PSC-Y correlated significantly with teacher and parent measures of child dysfunction, and with child-reported symptoms of depression and anxiety. Three quarters of the children identified by the PSC-Y were not identified by parents on the PSC. These children had impairment on all other measures, but fewer than one in five had received mental health services, suggesting the PSC-Y identified children with unmet mental health needs. The PSC-Y has the potential to be a rapid, easily administered tool for large-scale mental health screening in schools.
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Anderson DL, Spratt EG, Macias MM, Jellinek MS, Murphy JM, Pagano M, Griesemer DA, Holden KR, Barbosa E. Use of the pediatric symptom checklist in the pediatric neurology population. Pediatr Neurol 1999; 20:116-20. [PMID: 10082339 DOI: 10.1016/s0887-8994(98)00121-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of the Pediatric Symptom Checklist (PSC) as a mental health screening instrument in a busy pediatric neurology population in comparison with more lengthy, time-consuming assessment methods. One hundred two children were screened using the PSC. PSC results were compared with scores on the Child Behavior Checklist (CBCL), results from structured interviews, and ratings of adaptive functioning using the Children's Global Assessment Scale (CGAS). Thirty-nine of the patients (38%) scored 63 or above on the CBCL, indicating psychosocial impairment. Using a cutoff score of 22, the PSC correctly identified 35 of these 39 positive cases (sensitivity 89.7) and 48 of the 63 children with CBCL scores below 63 (specificity 76.2). CGAS scores were significantly negatively correlated with PSC scores (r = -0.60, P < 0.05). The PSC correctly identified 85.9% of children who scored 70 or below on the CGAS. Among the 53 children with psychiatric diagnoses on the basis of the interview, 41 scored above the cutoff of 22 on the PSC. Results suggest that the PSC is an efficient and accurate screen for identification of mental health problems in the pediatric neurology population.
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Affiliation(s)
- D L Anderson
- Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA
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Abstract
BACKGROUND Qualitative and quantitative studies have shown that cutaneous diseases can have significant effects on psychologic well-being and social functioning in a variety of interpersonal situations. OBJECTIVE Our purpose was to assess the nature and extent of the social and psychologic difficulties associated with vitiligo using a combination of qualitative and quantitative methods. METHODS Six hundred fourteen members of the U.K. Vitiligo Society completed a questionnaire that included the 12-item version of the General Health Questionnaire (GHQ) and an open-ended question concerning the effects of the disease on their life. RESULTS Thirty-five percent of the respondents scored above the threshold on the GHQ. Analysis of the qualitative data indicated that vitiligo affects lives in a variety of ways consistent with perceived stigma and that some categories of response (such as avoidance of activities and negative reactions by others) were associated with higher GHQ scores. CONCLUSION Many persons with vitiligo show indications of significant distress that are related to specific types of social encounters and emotional disturbance.
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Affiliation(s)
- G Kent
- Department of Psychiatry, Northern General Hospital, Sheffield, U.K
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Pagano M, Murphy JM, Pedersen M, Mosbacher D, Crist-Whitzel J, Jordan P, Rodas C, Jellinek MS. Screening for psychosocial problems in 4-5-year-olds during routine EPSDT examinations: validity and reliability in a Mexican-American sample. Clin Pediatr (Phila) 1996; 35:139-46. [PMID: 8904487 PMCID: PMC3277256 DOI: 10.1177/000992289603500305] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The effectiveness of the Pediatric Symptom Checklist (PSC) as a psychosocial screening measure to meet Federal Medicaid/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) requirements was examined in 117 low-income preschool (aged 4-5 years old) Hispanic children during well-child examinations in three clinics over an 8-month period. The PSC identified 7% of the sample as at risk for psychosocial problems. The PSC was significantly associated with parental ratings of the children's problems in functioning, with pediatric clinicians' decisions to make mental health referrals, with degrees of associations similar to those found between PSC scores, and with the same measures with school-aged children in the same clinics. Cronbach's alpha was high (r = .87) and virtually identical in English, Spanish, oral, and written formats. Although it identified a slightly lower rate of psychosocial problems in 4-5-year-olds than it had in school-aged children, the PSC appeared to provide an effective method of screening for psychosocial problems during EPSDT examinations.
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Affiliation(s)
- M Pagano
- Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA
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Lewis-Jones MS, Finlay AY. The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol 1995; 132:942-9. [PMID: 7662573 DOI: 10.1111/j.1365-2133.1995.tb16953.x] [Citation(s) in RCA: 581] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Skin disease can cause severe disability and handicap in children. Measurement of the impact of skin disease on the quality of life is required to aid clinical decision-making, for clinical research, for audit of paediatric dermatology services, and for political reasons, to aid arguments for more resources for the care of children with skin disease. Adult measures are inappropriate, as the lives of children differ markedly from those of adults. The purpose of this study was to create and initially validate a simple practical questionnaire for use in children. One hundred and sixty-nine children, aged 3-16 years, attending a paediatric dermatology clinic, wrote down, with the help of their parents, all the ways in which their skin disease affected their lives. One hundred and eleven different aspects were identified; 10 questions were composed to cover these aspects, using a structure similar to the Adult Dermatology Life Quality Index. This draft questionnaire was piloted on two series, totalling 40 children, and minor alterations were made to improve clarity. The Children's Dermatology Life Quality Index (CDLQI) questionnaire (maximum score 30) was then given to a further 233 dermatology paediatric out-patients (CDLQI mean = 5.1, SD = 4.9), 47 normal controls (mean 0.4, 0.7) and 55 control patients attending a general paediatric clinic (mean 0.7, 2.5). The CDLQI scores for eczema (mean = 7.7, 5.6, n = 47), psoriasis (5.4, 5.0, n = 25) and acne (5.7, 4.4, n = 40), were all highly significantly greater than for moles and naevi (2.3, 2.9, n = 29). The highest mean score was that for scabies (mean = 9.5, 10.5, n = 6).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M S Lewis-Jones
- Department of Dermatology, Wrexham Maelor Hospital, Clwyd, U.K
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Lloyd J, Jellinek MS, Little M, Murphy JM, Pagano M. Screening for psychosocial dysfunction in pediatric inpatients. Clin Pediatr (Phila) 1995; 34:18-24. [PMID: 7720323 DOI: 10.1177/000992289503400104] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Screening pediatric inpatients for psychosocial dysfunction offers physicians an opportunity to identify emotional and behavioral problems that might otherwise go unrecognized. In this study, the Pediatric Symptom Checklist (PSC), a brief, parent-completed questionnaire, which has been validated in a variety of outpatient settings, was used to screen 98 pediatric inpatients. Results indicated that the PSC can be easily administered in a busy inpatient setting and is well-tolerated by both house staff and patients' parents as a routine part of the admissions process. The percentage of children who screened positive with the PSC in this inpatient setting was similar to the percentages generated by using the PSC in outpatient settings. Routine use of the PSC in inpatient settings serves to heighten house staff awareness of psychosocial concerns and facilitate parent-physician discussion of pediatric mental health issues.
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Affiliation(s)
- J Lloyd
- Children's Service, Massachusetts General Hospital, Boston 02114, USA
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