J Pediatr Health Care. 2021 May-Jun;35(3):270-277. doi: 10.1016/j.pedhc.2020.08.004. Epub 2021 Feb 11.
Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening.
The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12-18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression.
Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant.
Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression.
尽管青少年抑郁的发病率不断上升，且有基于证据的建议推荐对青少年抑郁进行筛查，但仍有 70%的青少年表示他们并未与医疗服务提供者讨论过抑郁问题。本质量改进项目的目的是通过实施基于实践的普遍抑郁筛查，来提高青少年抑郁的识别率和管理率。
在过去的 3 个月里，对 12-18 岁的青少年进行年度健康检查时，采用青少年版患者健康问卷-9 对其进行抑郁筛查。通过回顾性病历分析，来确定抑郁筛查率、抑郁诊断率、转介至心理健康服务的比例，以及抗抑郁药物治疗率的变化。
比较了实施前后的数据。有记录的青少年抑郁筛查率从 0%上升到了 74.5%。诊断为抑郁症的比例（12.1%）、心理健康转介率（8%）和抗抑郁药物治疗率（4.9%）均有显著的临床和统计学意义。
在儿科初级保健中采用基于证据的普遍抑郁筛查建议，可以改善青少年抑郁的早期诊断和管理。
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