Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
Foresight Logic, Inc., Saint Paul, MN.
J Pediatr. 2021 Jun;233:220-226.e1. doi: 10.1016/j.jpeds.2021.01.069. Epub 2021 Feb 3.
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.
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.
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.
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.
比较使用父母报告的儿科症状清单（PSC-17P）和青少年修改后的患者健康问卷-9 项（PHQ-9M）来符合最近的青少年抑郁症筛查质量标准。
5411 名儿科门诊患者（11.0-17.9 岁）的父母完成了 PSC-17P，其中包含对整体（PSC-17P-OVR）、内化（PSC-17P-INT）、外化（PSC-17P-EXT）和注意力（PSC-17P-ATT）问题进行分类风险的量表。青少年完成了评估抑郁症状的 PHQ-9M。在儿科常规就诊前的 24 小时内，两种表格均在线完成。
共有 9.9%的患者（n=535）在 PSC-17P-OVR 上存在风险，14.3%的患者（n=775）在 PSC-17P-INT 上存在风险，17.0%的患者（n=992）在这两种量表或两者上存在风险（PSC-17P-OVR 和/或 PSC-17P-INT）。使用 PHQ-9M 的 10 分（中度-重度抑郁）临界值，另外 2.4%（n=131）被归类为存在风险，所有 PHQ-9M 阳性者（n=394）中有 66.8%（n=263）也通过 PSC-17P-OVR 和/或 PSC-17P-INT 量表被归类为存在风险。使用 PHQ-9M 的 15 分（重度-非常重度抑郁）临界值，只有 29 名患者（PHQ-9M 阳性者的 21.8%）未被 PSC-17P-OVR 和/或 PSC-17P-INT 量表识别为存在风险。
PSC-17P-OVR 和/或 PSC-17P-INT 量表联合使用可将 17%的青少年确定为抑郁症风险人群，其中约三分之二至四分之三的青少年被 PHQ-9M 归类为存在风险。这些发现支持使用 PSC-17P 来满足抑郁症的质量标准以及儿科的整体筛查。初级保健临床医生可以添加 PHQ-9M 来识别可能自我报告抑郁症状的其他青少年。
