Standardized Assessment Measures

A small number of standardized assessment tools and semistructured interviews are used in the specialty of adult psychosomatic medicine and can serve as a template for use in selected pediatric populations. These include the Primary Care Evaluation of Mental Disorders (PRIME-MD), a 26-item, self-administered questionnaire that screens for five of the most common groups of disorders in primary care: depression, anxiety, alcohol use, somatoform disorders, and eating disorders (Spitzer et al. 1994). The PRIME-MD has been adapted as a self-report measure called the PRIME-MD Patient Health Questionnaire (Spitzer et al. 1999). In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version (DSM-IV-PC; American Psychiatric Association 1995), contains diagnostic algorithms to evaluate eight common categories of psychiatric disorders, including depression, anxiety, cognitive abnormalities, substance use, unexplained physical symptoms, sleep and sexual disorders, weight and eating disorders, and psychosis.

For pediatric patients, a number of general measures of psychiatric functioning have been developed (see Table 3-5). In addition to the Child Behavior Checklist (Achenbach 1991), a number of well-validated semistructured interviews and self-report measures, such as the Semi-Structured Clinical Interview for Children and Adolescents (McConaughy and Achenbach 1994), can be used to assess the general areas of school, friends, family, relatives, fantasies, and self-perceptions, as well as academic achievement, fine motor skills, and gross motor skills. Also, a number of general psychiatric screening measures are available, including the widely used Pediatric Symptom Checklist (Jellinek et al. 1988).

Although no empirically based general psychosocial assessment interviews or measures are applicable in the field of pediatric psychosomatic medicine, some specialty-specific assessment instruments have been developed. For example, the Psychosocial Assessment Tool (Pai et al. 2008) is used to assess psychosocial stress in family members of children newly diagnosed with cancer. Similarly, a number of measures of parental stress have been adapted for parents of medically ill infants or for parents of infants hospitalized in the neonatal intensive care unit (Carter and Miles 1989; Miles and Brunssen 2003; Miles et al. 1993). Also, numerous instruments are available for use in the assessment of specific clinical symptom pictures, such as the assessment of delirium (Trzepacz et al. 2001) and of psychosocial risk factors in pediatric organ transplant recipients (Fung and Shaw 2008). Measures used in the assessment of pain and eating disorders are reviewed in Chapters 9 and 10, respectively.

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