PCPs Need More Training In Assessing and Treating Irritability in Children

MedicalResearch.com Interview with:
Anna Scandinaro
Medical student
Penn State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called “What is irritability?” which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5.

The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations.

In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful. 

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away from this report that there is a need for increased education and training for primary care providers in assessing and treating irritability in children and adolescents especially with the national shortage of child and adolescent psychiatrists in the country.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Currently we are in the process of implementing an educational follow-up study where we will distribute a resource with information on how to assess irritability and potential resources for support and treatment. We plan to distribute these to pediatric and family medicine primary care providers and then evaluate whether they were useful in everyday practice.

Overall, future research should be aimed at pragmatic and effective ways to increase education and training for primary care providers who diagnose and treat psychiatric illnesses in the primary care setting, where a majority of problems occur.

MedicalResearch.com: Is there anything else you would like to add? 

Response: Safety is always the most pressing concern. With increasing violence in the school aged population, we believe irritable mood can serve as an “emotional thermometer” which may indicate a time limited, less intense problem or a more serious condition.

This research was funded by the Qualitative Research Initiative Award (to Ms Scandinaro) and a small grant from the Penn State College of Medicine Department of Psychiatry to Dr. Usman Hameed, who is a coauthor on the publication. 

Citations:

Anna L. Scandinaro, Usman Hameed, Cheryl A. Dellasega. A Qualitative Study to Assess How Primary Care Versus Psychiatric Providers Evaluate and Treat Pediatric Patients With Irritability. The Primary Care Companion For CNS Disorders, 2018; 20 (2) DOI: 10.4088/PCC.17m02227 

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