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Biomedical subjects

Martin T Stein

Publications and source records attributed to Martin T Stein.

At least 19 recordsLinked to original sources
PubMed2005

Brief measures to screen for social phobia in primary care pediatrics.

OBJECTIVE: To evaluate the usefulness of screening measures to detect social phobia among youth in a primary care setting. METHODS: Families recruited from a pediatric primary care setting completed by mail the Social Anxiety Scale (SAS), the Social Worries Questionnaire (SWQ), and the social phobia subscale of the Screen for Child Related Anxiety Disorders (SCARED). Diagnoses were obtained from 190 parent interviews. Receiver operating characteristic (ROC) analyses were used to determine the utility of the measures as screening instruments. RESULTS: Most of the parent report measures, including the single item ("My child is shy") from the SCARED, were at least moderately accurate screeners and performed best for the generalized subtype of social phobia. CONCLUSION: The use of valid, brief screening instruments can significantly improve the feasibility of detecting social phobia among youth in primary care pediatric settings.

Adolescent↗
PubMed2005

Treatment of attention-deficit/hyperactivity disorder: overview of the evidence.

The American Academy of Pediatrics' Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder, reviewed and analyzed the current literature for the purpose of developing an evidence-based clinical practice guideline for the treatment of the school-aged child with attention-deficit/hyperactivity disorder (ADHD). This review included several key reports, including an evidence review from the McMaster Evidence-Based Practice Center (supported by the Agency for Healthcare Research and Quality), a report from the Canadian Coordinating Office for Health Technology Assessment, the Multimodal Treatment for ADHD comparative clinical trial (supported by the National Institute of Mental Health), and supplemental reviews conducted by the subcommittee. These reviews provided substantial information about different treatments for ADHD and their efficacy in improving certain characteristics or outcomes for children with ADHD as well as adverse effects and benefits of multiple modes of treatment compared with single modes (eg, medication or behavior therapies alone). The reviews also compared the effects of different medications. Other evidence documents the long-term nature of ADHD in children and its classification as a chronic condition, meriting the application of general concepts of chronic-condition management, including an individual treatment plan with a focus on ongoing parent and child education, management, and monitoring. The evidence strongly supports the use of stimulant medications for treating the core symptoms of children with ADHD and, to a lesser degree, for improving functioning. Behavior therapy alone has only limited effect on symptoms or functioning of children with ADHD, although combining behavior therapy with medication seems to improve functioning and may decrease the amount of (stimulant) medication needed. Comparison among stimulants (mainly methylphenidate and amphetamines) did not indicate that 1 class outperformed the other.

Adolescent↗
PubMed2004

Child anxiety in primary care: prevalent but untreated.

We present prevalence and treatment utilization rates for child anxiety disorders in a university-affiliated primary care clinic. Families were recruited from a pediatric patient list and 714 families participated in an initial study wherein they completed child anxiety questionnaires. According to parent and child self-report questionnaires (n=714), 22% and 20% of children, respectively, were above a suggested clinical cutoff on a brief anxiety screen; 19% and 14% of children exceeded clinical cutoffs on a separate social anxiety questionnaire. All families were invited to participate in a second study that included the Anxiety Disorders Interview Schedule for Children-Parent Version and questions about treatment utilization; telephone interviews with 190 parents showed 1-year prevalence rates of DSM-IV child disorders to be 10.0% (se=2.2%) for specific phobia, 6.8% (se=1.8%) for social phobia, 3.2% (se=1.3%) for generalized anxiety disorder, 0.5% (se=.7%) for selective mutism, 1.6% (se=.9%) for major depressive disorder, 1.1% (se=.7%) for dysthymia, and 12.6% (se=2.4%) for attention deficit-hyperactivity disorder (ADHD). Among children with a current anxiety disorder, 31% had received counseling or medication treatment during their lifetime, compared to 40% of children with depression and 79% with ADHD. Adolescent age and being Caucasian were predictors of psychotherapy use; having an ADHD diagnosis was a predictor of both psychotherapy and medication use. The high prevalence of impairing anxiety disorders, in concert with the very low extent of treatment utilization, suggests a need for methods to identify and disseminate empirically validated treatments for these disorders in the primary care setting.

Adolescent↗
PubMed2004

Comorbidity of generalized social anxiety disorder and depression in a pediatric primary care sample.

BACKGROUND: Comorbidity between adult social anxiety disorder and major depression is extensive. Considerably less information about this relationship is available among youth. METHODS: A randomly selected (from enrollees in a pediatric primary care clinic) sample of 190 families with children between the ages of 8 and 17 responded by mail to questionnaires assessing social anxiety, depression, and social functioning. Parents also completed a semi-structured telephone diagnostic interview about their child. RESULTS: The generalized type of social anxiety disorder was highly comorbid with major depression, generalized anxiety disorder, specific phobias, and ADHD, while little comorbidity was present for the nongeneralized subtype of social anxiety disorder. Logistic regression analyses indicated that generalized social anxiety disorder was the only anxiety disorder associated with an increased likelihood of major depression (OR=5.1). In all cases, social anxiety disorder had a significantly earlier age of onset than major depression. LIMITATIONS: This study relies on cross-sectional data and diagnoses are based on parent reporting of child behavior. CONCLUSIONS: Generalized social anxiety disorder is strongly associated with depressive illness in youth. Screening and treatment approaches that consider both social anxiety and depressive symptoms are necessary. Early intervention to treat social anxiety disorder may prevent later depressive disorders.

Adolescent↗