Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder that affects 3-5 percent of all American children. Today pediatricians appear to be treating more children with these behavioral health problems. However, a new study from Wake Forest University Baptist Medical Center suggests that they do not always feel comfortable or sufficiently trained to tackle the increasing growth in patient numbers.
The study involved interviews with community pediatricians who estimated that an average of about 15 percent of the children they see have behavioral health problems, said Jane Williams, Ph.D., lead author of the study. The report was published in the September issue of Pediatrics.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral health disorder seen by pediatricians, she said. The pediatricians "expressed a high level of comfort with the diagnosis and frequently or occasionally prescribed stimulants" to treat it.
But when a child is suffering from anxiety or depression, the pediatricians felt they were on shakier grounds. Fewer than half the pediatricians said they diagnosed anxiety and depression frequently. Those that did typically used questionnaires in making the diagnosis and prescribed drugs from a class that includes Prozac, Zoloft and Paxil.
The study found a "strong interest in diagnosing and treating behavioral health disorders within their perceived limits and level of comfort," Williams and her Wake Forest Baptist colleagues reported. "They were very concerned about the correctness of these diagnoses and consider the impact on both the child and family."
The researchers said pediatricians are treating more children with psychiatric problems in part because of chronic underfunding of the public mental health system. Only about 2 percent of the children who need treatment are seen by mental health specialists.
In fact, the diagnosis and treatment of ADHD has shifted primarily to pediatricians, the results showed. "The diagnosis of anxiety and depression appeared to be shifting more gradually to pediatric providers," Williams said.