Why your doctor may be unsure about your child's moodiness

All children go through moments of irritability and is a normal part of their growing up.
But on-going irritability can be worrying for parents who will refer their child to a family doctor just to make sure that the irritability and moodiness is not related to any mental health issues.
But can family doctors and paediatricians really tell if such irritability in children is normal?
Children’s mental health is of immense importance and this study tells us that primary care providers, who are often the first clinician consulted, find it difficult to assess irritability in children and have a very different treatment approach than psychiatrists.
A study from Penn State University found that family medicine doctors and paediatricians were less confident than child and adolescent psychiatrists in their ability to tell whether the irritability in children was normal or could be linked to deeper mental issues.
For this study 17 providers from family medicine, paediatrics, and psychiatry were recruited from a large medical centre and were interviewed on how they define irritability in children, how they evaluate irritability and how they differentiate between normal and abnormal irritability.
Demographic data and information regarding their confidence was also collected and measured.
The study found that primary care – family medicine doctors and paediatricians – felt that they did not have the necessary training or the resources to evaluate a child in a clinical setting in the amount of time that they had.
They also found that primary care providers were more likely to prescribe medication when they thought there was a problem while child or adolescent psychiatrists usually initiated behavioural therapy.
The researchers also found that family medicine providers looked for anxiety and problems in school as symptoms of irritability. However psychiatrists usually checked for negative moods or if children had a hard time dealing with frustration.
Primary care providers also reported being comfortable prescribing medications but would be more likely to refer the patient to a specialist if more stronger medications and treatment were needed.
Irritability in children can be hard to differentiate – whether it is normal irritability or chronic irritability which can be signal further mental health issues.
Children’s mental health is of immense importance and this study tells us that primary care providers, who are often the first clinician consulted, find it difficult to assess irritability in children and have a very different treatment approach than psychiatrists.
This clearly shows that education about childhood irritability for primary care providers needs to be improved.
Researchers also suggest the development of a tool which helps them assess childhood irritability – if it is normal or if the child needs to be referred to a specialist.
The researchers also inform that it’s important for parents to go with their gut feeling when they see their child exhibit such behaviour and it’s best to consult with their doctor on this matter.
Source: The Primary Care Companion For CNS Disorders
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