儿科耳鼻喉科诊所中的抑郁。

Depression in the Pediatric Otolaryngology Clinic Setting.

机构信息

University of California San Diego School of Medicine, La Jolla, California, U.S.A.

Rady Children's Hospital of San Diego, San Diego, California, U.S.A.

出版信息

Laryngoscope. 2022 May;132(5):1104-1111. doi: 10.1002/lary.29856. Epub 2021 Sep 7.

DOI:10.1002/lary.29856

PMID:34464458

Abstract

OBJECTIVES/HYPOTHESIS: For most pediatric specialty clinics, mental health is not the primary presenting complaint, yet can portend unrecognized morbidity. We describe rates and risk factors of depression and suicidal ideation in adolescents seen at a pediatric specialty clinic and examine changes during COVID-19.

STUDY DESIGN

Retrospective database review.

METHODS

Outpatient pediatric otolaryngology clinic encounters of patients aged 12-19 years at a tertiary academic medical center were identified from October 2018 to July 2020. Demographic characteristics, ICD-10 primary diagnosis, Patient Health Questionnaire (PHQ)-2 score, and PHQ-9 score (if administered) were obtained. Multivariable regression examined risk factors for PHQ-9 administration, PHQ-9 scores ≥10, and suicidal ideation. Patient characteristics and PHQ scores were compared before and after March 23, 2020 (California COVID-19 Stay-at-Home order).

RESULTS

Three thousand six hundred nine encounters with PHQ-2 data were identified. Of these, 223 (6.2%) scored ≥3 and underwent PHQ-9 assessment, of which 121 (3.4% of 3,609) scored ≥10 on the PHQ-9 and 53 (1.5%) endorsed suicidal ideation. Factors associated with PHQ-9 administration were female gender (odds ratio [OR] 1.58, P = .001), obesity (OR 1.48, P = .043), and neck mass/neoplasm/cancer diagnosis (OR 1.99, P = .013). Female gender was also associated with suicidality (OR 2.47, P = .008). Comparison of pre-COVID-19 versus during COVID-19 showed no differences in depression or suicidality. However, subgroup analysis revealed some significant findings.

CONCLUSIONS

We demonstrate substantial prevalence of positive depression screening and suicidal ideation among adolescent pediatric otolaryngology clinic encounters. Depression rates were similar to pre-COVID-19 and during COVID-19, yet barriers to screening during this time were substantial. Pediatric specialty providers must remain vigilant for mental health issues in their patients.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:1104-1111, 2022.

摘要

目的/假设：对于大多数儿科专科诊所来说，心理健康并不是主要的就诊主诉，但可能预示着未被识别的发病率。我们描述了在儿科专科诊所就诊的青少年中抑郁和自杀意念的发生率和风险因素，并检查了 COVID-19 期间的变化。

研究设计

回顾性数据库研究。

方法

从 2018 年 10 月至 2020 年 7 月，在一家三级学术医疗中心，从 12-19 岁的门诊儿科耳鼻喉科诊所就诊患者中确定了患者的人口统计学特征、ICD-10 主要诊断、患者健康问卷（PHQ-2）评分和（如果进行）PHQ-9 评分。多变量回归分析了 PHQ-9 评估、PHQ-9 评分≥10 和自杀意念的风险因素。比较了 2020 年 3 月 23 日（加利福尼亚州 COVID-19 居家令）前后的患者特征和 PHQ 评分。

结果

确定了 3609 次有 PHQ-2 数据的就诊，其中 223 次（6.2%）评分≥3，并进行了 PHQ-9 评估，其中 121 次（3.609 次中的 3.4%）PHQ-9 评分≥10，53 次（1.5%）有自杀意念。与 PHQ-9 评估相关的因素是女性（比值比 [OR] 1.58，P =.001）、肥胖（OR 1.48，P =.043）和颈部肿块/肿瘤/癌症诊断（OR 1.99，P =.013）。女性也与自杀意念相关（OR 2.47，P =.008）。与 COVID-19 前相比，COVID-19 期间的抑郁或自杀率无差异。然而，亚组分析显示出一些显著的发现。