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Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre
  1. Mohamed Mansour1,
  2. Dharshana Krishnaprasadh1,2,
  3. Janice Lichtenberger1,
  4. Jonathan Teitelbaum1
  1. 1Department of Pediatrics, Monmouth Medical Center, Long Branch, New Jersey, USA
  2. 2Beaumont Health, Royal Oak, Michigan, USA
  1. Correspondence to Dr Mohamed Mansour; mmansour.md{at}outlook.com

Abstract

Background Depression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression.

Methods In this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age.

Results It was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period.

Conclusion Standardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.

  • quality improvement
  • mental health
  • PDSA
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Footnotes

  • Contributors MM designed the study, did substantial work in the analysis and interpretation of the data, revised the work, approved the final version to be published and agreed to be accountable for all aspects of the work. DK did substantial work in the analysis and interpretation of the data, revised the work, approved the final version to be published and agreed to be accountable for all aspects of the work. JL designed the study, did substantial work in the analysis and interpretation of the data, revised the work, approved the final version to be published and agreed to be accountable for all aspects of the work. JT did substantial work in the analysis and interpretation of the data, revised the work, approved the final version to be published and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to this study are included in the article.

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