Psychosocial problems’ screening in Primary Care

Psychosocial problems are prevalent in childhood and primary care pediatricians should improve our ability to detect them. Orientation and early diagnosis reduce morbidity and improve prognosis. For this reason we propose the introduction of a screening tool in the children?s health programme. We have used a questionnaire validated with Spanish population: the Strengths and Difficulties Questionnaire (SDQ). It is easy to use and it has proved to be efficient in primary care.

We present our experience applying the SDQ, parent version, in a primary care centre. It has been applied in the 5-6 years old children health control for two years.

Results: we have identified 15% of the children presenting some difficulties. The most common problems found at this age are behavioural problems. Parent's psychiatric conditions and monoparentality are predisposing factors that can lead to emotional and relation problems. Immigrant children present a high incidence in relation problems with their equals. The incorporation of other information sources such as the teachers, could improve the screening performance.

Conclusion: the parent-SDQ is a useful tool in primary care for the screening of childhood psychosocial problems. It is well accepted by the families and it is easily interpreted by the professionals. More studies are necessary to develop an algorithm that can help professionals to decide when it is necessary to ask for information to the Educative Services in order to improve our diagnosis capacity.