Psychiatric disorders in adolescents in primary care

Background Little is known about psychiatric disorders in adolescents who a ttend primary care. Method Prospective study of 13- to 16-year-olds consecutively attending gen eral practice, information was obtained from adolescents, parents and gener al practitioners, using questionnaires and research interviews. Results 136/200 (68%)of adolescent attenders took part. Two per cent presen ted with psychiatric complaints. From research interviews with adolescents, psychiatric disorder in the previous year was found in 38%, with moderate impairment of functioning in over half (according to Children's Global Asse ssment Scale scores). Most disorders (42/50, 84%) were emotional ('internal ising') disorders. Psychiatric disorders were significantly associated with high levels and intensity of physical symptoms and with increased health r isks. General practitioner assessment of psychiatric disorders was low on s ensitivity (20.8%) but high on specificity (90.7%). Doctors identified most severely affected adolescents. Conclusions Depressive and anxiety disorders are common among adolescent ge neral practice attenders and linked to increased physical symptoms; general practitioner recognition is limited.