Comparison of mental health symptoms between children attending developmental/behavioural paediatric clinics and child and adolescent mental health service

Abstract

Australian paediatricians are being referred many children with severe and complex behavioural presentations. Australian paediatricians are being referred many children with severe and complex behavioural presentations. The aim of this study was to compare patients seen in the developmental/behavioural paediatric clinic (DBP) with those seen in the community child and adolescent mental health service (CAMHS) of a paediatric teaching hospital. We hypothesised that the burden of emotional-behavioural symptoms of children referred to these two services would be similar. The Strengths and Difficulties Questionnaire was completed by parents of children seen in both the DBP and the CAMHS of a paediatric teaching hospital over a 6-month period. The self-report version was completed by patients aged over 11 years. Data were compared both continuously and categorically, for total scores and subscale scores. For patients aged 4-10 years, the total scores were higher for the CAMHS (mean=20.4) than the DBP (mean=16.6) sample (P<0.001). For patients aged 11-17 years, there was no difference between the groups in either the parent report total scores (CAMHS 19.4; DBP 19.3, P=0.92) or the self-report total scores (CAMHS 17.5; DBP 15.7, P=0.11). Children referred to a DBP clinic had a comparable burden of emotional/behavioural symptoms to those referred to a CAMHS service, although the degree of impairment was higher in the CAMHS sample. The complexity and severity of clinical work undertaken in DBP services needs to be taken into account in paediatric training, and in the broad planning of child and adolescent mental health service delivery.