Can the Child Behavior Checklist (CBCL) help characterize the types of psychopathologic conditions driving child psychiatry referrals?

BACKGROUND

Little is known about the scope of problems driving referrals to child and adolescent psychiatry services. Identifying the full range of mental disorders affecting a particular child can help triage the child to a clinician with the appropriate level of expertise. The Child Behavior Checklist (CBCL) is an easy-to-use assessment tool that may provide invaluable information regarding the severity of the presenting complaints and also aid in the referral process.

OBJECTIVE

To assess the utility of the CBCL to gain insights into the type of clinical problems driving referrals of youth to an outpatient pediatric psychiatry clinic.

METHOD

The sample consisted of 418 newly referred youth 4-18 years of age of both sexes. Parents completed the CBCL assessing psychopathology and competence. Rates of patients with elevated T-scores on each scale were calculated for the whole group and stratified by sex and age (≤12 versus >12).

RESULTS

The CBCL identified high rates of psychopathology affecting referred youth. It also provided information on the type of suspected disorders affecting a particular child as well as their severity, critical information to guide likely differing clinical needs and therapeutic approaches. It also helped identify a high number of youth affected with multiple psychopathological conditions, likely to require a high level of clinical attention. Overall, males were significantly more impaired than females but there were no major differences between children and adolescents.

CONCLUSIONS

The CBCL can aid in the identification of individual and comorbid mental disorders affecting youth seeking mental health services by providing specific information about the presence and the severity of specific suspected disorder. These findings have implications for prioritizing scarce resources in child mental health and for improved consideration of the complexity of clinical presentations to pediatric psychiatry programs of any type.

Déclaration de conflit d'intérêts

Conflicts of interest Dr. Biederman reports research support from: MGH Pediatric Psychopharmacology Council Fund, American Academy of Child and Adolescent Psychiatry, Feinstein Institute for Medical Research, Food & Drug Administration, Genentech, Headspace Inc., National Institute on Drug Abuse, Pfizer Pharmaceuticals Inc., Tris, National Institutes of Health, Lundbeck AS, and Neurocentriaa Inc. during the conduct of the study. Departmental Royalties from copyrighted rating scale used for ADHD diagnoses from: Bracket Global, Ingenix, Prophase, Shire, Sunovion, and Theravance outside the submitted work. In addition, Dr. Biederman has a patent US Patent (#14/027,676) licensed to MGH Corporate Licensing, a patent US Patent (#10,245,271 B2) licensed to MGH Corporate Licensing, and a patent (#61/233,686) pending. Dr. Vaudreuil reports that the study was supported in part from Louis V. Gerstner III Research Scholars Program, during the conduct of the study. Dr. Wozniak reports research support from PCORI, Demarest Lloyd, Jr. Foundation, Eli Lilly, Janssen, McNeil, Merck/Schering-Plough, National Institutes of Mental Health, Pfizer, Shire, other from Bantam Books, outside the submitted work. Dr. Faraone reports income, potential income, travel expenses, continuing education support and/or research support from Rhodes, OnDosis, Tris, Otsuka, Arbor, Ironshore, Takeda, and Genomind; research support from Shire, Enzymotec, Neurovance, Alcobra, CogCubed, KemPharm, Neurolifesciences Lundenback/Takeda, Otsuka, other from McNeil, Janssen, Novartis, Pfizer, and Eli Lilly; royalties from from Guiliford Press, Oxford University Press, and Elsevier. Dr. Faraone is Principal Investigator at www.adhdinadults.com outside the submitted work. Drs. Maura DiSalvo, Mai Uchida, K. Yvonne Woodworth and Allison Green report no conflicts of interest.