Reported physician skills in the management of children's mental health problems following an educational intervention.

OBJECTIVE: The tristate Reaching Children Initiative (RCI) was designed to engage primary care physicians (PCPs) and increase reported knowledge and skills in the diagnosis and management of the most common mental health (MH) problems among children and adolescents. METHODS: PCPs responded to a baseline survey and agreed to participate in an educational intervention or serve in a comparison group. The program, delivered by an interdisciplinary faculty, engaged the audience in role play, motivational techniques, and didactics. To assess the overall effectiveness of the intervention, baseline, and 6-month follow-up, surveys asked PCPs to rate their knowledge, diagnostic skills regarding socioemotional problems, knowledge of treatment strategies for these problems, awareness of MH resources, and attitudes towards diagnosing and treating MH problems. RESULTS: Of the 215 baseline respondents, 137 chose to participate in the educational intervention and 78 served as a comparison group; of these, 64% and 59%, respectively, completed the 6-month survey. The overall sample was predominantly female (70.2%), white (64.7%), and had been in practice for over 10 years (57.5%). Repeated measures analysis, confirmed by propensity analyses, revealed significantly improved reported mean scores for diagnostic skills and knowledge of clinical strategies for the intervention relative to the comparison group. The intervention did not significantly impact awareness of resources or attitudes. CONCLUSIONS: Following the RCI, PCPs did report significant changes in self-efficacy specific to diagnostic skills and knowledge of clinical treatment strategies for targeted MH content. This educational approach merits further study.

Use of a psychosocial screen to detect children with symptoms of posttraumatic stress disorder: an exploratory study.

OBJECTIVE: The aim of this study was to evaluate the sensitivity and specificity of the parent and youth versions of the 17-item Pediatric Symptom Checklist (PSC-17) for identifying children with symptoms of posttraumatic stress disorder (PTSD). METHODS: Cross-sectional convenience samples of children aged 8 to 10 years treated at a primary care pediatrics practice in New York City were recruited. The PSC-17 and its 5-item internalizing subscale were used in both parent- and youth-completed formats. Posttraumatic stress disorder symptoms were identified with the University of California, Los Angeles posttraumatic stress reaction index (UCLA RI), used as a structured interview with the child. RESULTS: One hundred fifty-six children enrolled in the study. Twenty-two percent of children met the UCLA RI cutoff for likely PTSD. The youth version of the PSC-17 and its 5-item internalizing subscale identified these children with sensitivities of 78% and 75% and specificities of 77% and 77%, respectively, relative to the UCLA RI. The parent version of the PSC-17 and the internalizing subscale had poorer sensitivities of 44% and 25% and similar specificities of 79% and 92%, respectively. CONCLUSIONS: Symptoms of PTSD can be identified using the youth self-report version of the PSC-17. A 5-item subscale of the PSC-17 also performed well and can readily be used in primary care settings.