Adolescents consulting general practitioners for psychological problems-a nationwide, register-based study in Norway.

Abstract

BACKGROUND: Psychological problems are increasing among adolescents, but little is known about the role of GPs in this area. OBJECTIVES: This study aims to investigate the frequency of GP consultations with a psychological diagnosis in adolescence and predictors for such help seeking. METHODS: Nationwide longitudinal register-based study investigating GP consultations among adolescents aged 13-17 years (N = 123 516) in Norway. First, all GP consultations within the study population were identified from the national GP claims register for 2006-11. Second, adolescents with a first-time consultation with a psychological diagnosis at age 15-16 years were identified, and prior GP consultations, prior somatic diagnoses, parental education and GP and GP-practice characteristics were assessed as possible predictors for seeking help. RESULTS: From age 13 to 17 years, 15.3% of girls and 13.0% of boys had ≥1 GP consultation with a psychological diagnosis. In total, 6.8% of girls and 4.8% of boys consulted a GP for the first time with a psychological problem at age 15-16 years. For both sexes, number of prior GP consultations and a prior diagnosis of headache and abdominal pain predicted consulting with an internalizing problem (depression, anxiety and stress). A prior headache diagnosis predicted consulting for behavioural problems. Psychological diagnoses were more often found among adolescents with lower parental education. There were only minor associations with GP characteristics. CONCLUSIONS: Norwegian adolescents often consult a GP and one in seven had a GP-diagnosed psychological problem at age 13-17. Policies to improve mental health care for adolescents should include strengthening of GP services.