Introduction

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.

Method

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.

Results

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.

Discussion

Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression.

中文翻译：

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普遍青少年抑郁筛查的实施：质量改进结果

介绍

尽管青少年抑郁症、自杀和基于证据的青少年抑郁症筛查建议的发生率不断增加，但 70% 的青少年报告说没有与他们的提供者讨论抑郁症。该质量改进项目的目的是通过实施基于实践的普遍抑郁症筛查来改进青少年抑郁症的识别和管理。

方法

针对 12-18 岁青少年超过 3 个月的年度健康访问期间实施了针对青少年修改的患者健康问卷 9。进行回顾性图表审查以确定抑郁症筛查、抑郁症诊断、心理健康转诊和抑郁症药物治疗率的变化。

结果

比较了实施前/实施后的数据。记录在案的青少年抑郁症筛查从 0% 增加到 74.5%。诊断出的抑郁症 (12.1%)、心理健康转诊 (8%) 和抑郁症药物治疗 (4.9%) 的增加率具有临床和统计学意义。

讨论

在儿科初级保健中采用基于证据的普遍抑郁症筛查建议可以改善青少年抑郁症的早期诊断和管理。