Mental health in pediatric settings: Distribution of disorders and factors related to service use

Margaret J. Briggs-Gowan, Sarah Mc Cue Horwitz, Mary E. Schwab-Stone, John M. Leventhal, Philip J. Leaf

Research output: Contribution to journalArticlepeer-review

245 Scopus citations


Objectives: To examine child psychiatric disorders in pediatric settings and identify factors associated with parents' use of pediatricians as resources concerning emotional/behavioral issues and use of mental health services. Method: The sample consists of 5- to 9-year-olds (mean = 7.17 years, SD = 1.41) from a representative sample (N = 1,060) of pediatric practices. Parent interviews included assessments of psychiatric disorders with the Diagnostic Interview Schedule for Children (DISCR), parental depression/anxiety, possible child abuse, stress, support, and the use of mental health services. Results: The prevalence of any DISC disorder was 16.8%. Parental depression/anxiety and possible child abuse were associated independently with 2- to 3-times higher rates of disorder. Many parents (55%) who reported any disorder did not report discussing behavioral/emotional concerns with their pediatrician. Factors associated with discussing behavioral/emotional issues were the presence of any disorder and financial stress. Factors related to seeing a mental health professional were discussing behavioral/emotional issues with the pediatrician, single parenthood, and stressful life events. Conclusions: The prevalence rates of disorders in this setting suggest that pediatricians are well-placed to identify and refer children with psychiatric disorders. However, most parents do not discuss behavioral/emotional issues with their pediatrician. Methods for improving rates of identification and referral (e.g., routine screening) are considered.

Original languageEnglish (US)
Pages (from-to)841-849
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number7
StatePublished - 2000


  • Child psychiatric disorder
  • Pediatrician
  • Service use

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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