Department of Psychiatry, University of Washington, Seattle Children's Hospital, Seattle, WA 98195, USA.
Gen Hosp Psychiatry. 2013 Jul-Aug;35(4):444-7. doi: 10.1016/j.genhosppsych.2013.04.002. Epub 2013 May 4.
This study examined differences in co-occurring symptoms, psychosocial correlates, health care utilization and functional impairment in youth who screened positive for depression, stratified by whether or not they also self-reported externalizing problems.
The AdoleSCent Health Study examined a random sample of youth ages 13-17 enrolled in a health care system. A total of 2291 youth (60.7% of the eligible sample) completed a brief depression screen: the two-item Patient Health Questionnaire. The current analyses focus on a subset of youth (n=113) who had a follow-up interview and screened positive for possible depression on the Patient Health Questionnaire 9 using a cutoff score of 11 or higher [1]. Youth were categorized as having externalizing behavior if their score was ≥ 7 on the Pediatric Symptom Checklist (PSC) externalizing scale [2,3]. χ(2) tests and Wilcoxon rank sum tests were used to compare groups.
Differences between groups included that youth with depression and externalizing symptoms had a higher rate of obesity and had higher self-reported functional impairment than youth with depression symptoms alone.
Adding screening for externalizing problems to existing recommendations for depression screening may help primary care providers to identify a high-risk depressed group of youth for referral to mental health services.
本研究通过考察同时出现的症状、心理社会相关因素、卫生保健利用情况和功能损害在筛查出患有抑郁症的青少年中的差异，以及是否存在外化问题，对其进行分层研究。
青少年健康研究调查了参加医疗保健系统的 13-17 岁青少年的随机样本。共有 2291 名青少年（合格样本的 60.7%）完成了简短的抑郁筛查：两项目患者健康问卷。目前的分析集中在一小部分青少年（n=113）上，他们在患者健康问卷 9 上使用 11 分或更高的截定点筛查出可能患有抑郁症[1]。如果青少年在儿科症状清单（PSC）外化量表上的得分≥7，则将其归类为有外化行为[2,3]。 χ(2)检验和 Wilcoxon 秩和检验用于比较组间差异。
两组之间的差异包括，同时出现抑郁和外化症状的青少年肥胖率更高，自我报告的功能损害程度高于仅出现抑郁症状的青少年。
将外化问题的筛查加入到现有的抑郁筛查建议中，可能有助于初级保健提供者识别有高危抑郁的青少年群体，以便转介到心理健康服务机构。
