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Recognizing Adolescent Depression with Parent- and Youth-Report Screens in Pediatric Primary Care - 21/05/21

Doi : 10.1016/j.jpeds.2021.01.069 
Michael Jellinek, MD 1, 2, 3, Paul Bergmann, MA 4, Juliana M. Holcomb, BA 1, Alexa Riobueno-Naylor, BA 5, Anamika Dutta, BA 1, Haregnesh Haile, BS 6, Raymond Sturner, MD 7, 8, Barbara Howard, MD 7, 9, J. Michael Murphy, EdD 1, 2, ⁎
1 Department of Psychiatry, Massachusetts General Hospital, Boston, MA 
2 Department of Psychiatry, Harvard Medical School, Boston, MA 
3 Department of Pediatrics, Harvard Medical School, Boston, MA 
4 Foresight Logic, Inc., Saint Paul, MN 
5 Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College, Boston, MA 
6 Department of Psychology, The Catholic University of America, Washington, DC 
7 Department of Pediatrics, The John Hopkins University School of Medicine, Baltimore, MD 
8 Center for Promotion of Child Development through Primary Care, Baltimore, MD 
9 Total Child Health, Baltimore, MD 

∗Reprint requests: J. Michael Murphy, EdD, Massachusetts General Hospital, Department of Psychiatry and Harvard Medical School, Department of Psychiatry, 32 Fruit St, Boston, MA 02114Massachusetts General HospitalDepartment of Psychiatry and Harvard Medical SchoolDepartment of Psychiatry32 Fruit StBostonMA02114

Abstract

Objectives

To compare the use of the parent-report Pediatric Symptom Checklist (PSC-17P) and youth-report Patient Health Questionnaire-9 Modified for Teens (PHQ-9M) in compliance with recent quality standards for adolescent depression screening.

Study design

Parents of 5411 pediatric outpatients (11.0-17.9 years old) completed the PSC-17P, which contains scales that assign categorical risk for overall (PSC-17P-OVR), internalizing (PSC-17P-INT), externalizing (PSC-17P-EXT), and attention (PSC-17P-ATT) problems. Adolescents completed the PHQ-9M, which assesses depressive symptoms. Both forms were completed online within 24 hours of each other before pediatric well-child visits.

Results

A total of 9.9% of patients (n = 535) were at risk on the PSC-17P-OVR, 14.3% (n = 775) were at risk on the PSC-17P-INT, and 17.0% (n = 992) were at risk on either or both scales (PSC-17P-OVR and/or PSC-17P-INT). Using the PHQ-9M cut-off score of 10 (moderate-very severe depression), an additional 2.4% (n = 131) were classified as at risk, with 66.8% (n = 263) of all PHQ-9M positives (n = 394) also coded as at risk by the PSC-17P-OVR and/or PSC-17P-INT scales. Using a PHQ-9M cut-off score of 15 (severe-very severe depression), only 29 patients (21.8% of the PHQ-9M positives) not identified by the PSC-17P-OVR and/or PSC-17P-INT were classified as being at risk.

Conclusions

The combined PSC-17P-OVR and/or PSC-17P-INT scales identified 17% of adolescents as at risk for depression, including about two-thirds to three-quarters of adolescents classified as at risk on the PHQ-9M. These findings support using the PSC-17P to meet quality standards for depression as well as overall screening in pediatrics. Primary care clinicians can add the PHQ-9M to identify additional adolescents who may self-report depressive symptoms.

El texto completo de este artículo está disponible en PDF.

Abbreviations : CHADIS, GLAD-PC, PCP, PHQ-9M, PSC-17P, PSC-17P-INT, PSC-17P-OVR, WCV


Esquema


 Funding and disclsoure information is available at www.jpeds.com.


© 2021  Elsevier Inc. Reservados todos los derechos.
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Vol 233

P. 220 - juin 2021 Regresar al número
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