Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

Abstract

BackgroundDepression, 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.MethodsIn 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.ResultsIt 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.ConclusionStandardised 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.

Implementation of child-centred outcome measures in routine paediatric healthcare practice: a systematic review

“…It served both as an indicator of patient progress but also reportedly enabled psychologists to clearly identify areas of deficits (e.g., physical activity and sleep) that could be targeted for specific intervention in treatment. Psychologists’ observations were that patients became encouraged if their scores/run charts visibly dropped (indicating less functional disability), and they frequently remembered their scores from previous sessions without clinician prompting Mansour (2020); USA; Quality Improvement [ 64 ] To implement a standardised questionnaire to improve screening for depression by 60% in adolescents from 12 to 17 years of age N = 109 ; Primary Care; 12–17 years; depression PHQ-A; CYP self-report only; administered by professionals in session By the end of the study period, screening rate had increased from 0 to 70%. Lack of resident education causing poor adherence was identified as a barrier.…”

“…With respect to study design, n = 17 studies used mixed methods [ 58 , 65 , 72 , 75 , 79 , 82 , 86 , 89 , 90 , 95 , 99 , 100 , 102 , 103 , 106 , 107 , 109 , 110 ]; n = 15 studies used qualitative methods [ 46 , 52 , 55 , 57 , 60 , 67 , 70 , 76 , 78 , 80 , 91 , 93 , 94 , 105 , 108 ]. N = 12 studies were non-randomised experimental studies [ 44 , 54 , 61 , 68 , 69 , 71 , 77 , 81 , 85 , 92 , 96 , 101 ], and n = 12 were quality improvement projects [ 42 , 43 , 45 , 47 – 49 , 51 , 53 , 62 – 64 , 98 ]. There were n = 5 studies used cross-sectional designs [ 50 , 59 , 73 , 74 , 97 ], n = 4 case reports […”

“…A further n = 2 articles reported on studies conducted across secondary mental health care settings and the community [ 65 , 77 ]. There were n = 12 articles reporting on studies conducted in primary care settings [ 42 , 43 , 45 , 49 , 53 , 57 , 64 , 67 , 71 , 99 , 100 , 107 , 109 ], and n = 2 articles reported on studies conducted across primary care and community settings [ 48 , 55 ]. N = 2 articles reported on studies took place solely in the community [ 78 , 108 ] and n = 1 took place across multiple settings, but did not specify details [ 83 ].…”

Estratégias de prevenção do suicídio e da autolesão voltadas para adolescentes em ambientes escolares: uma revisão integrativa da literatura

“…Os autores ainda ressaltam que se houver diminuição entre os casos de comportamentos suicidas, autolesivos e sintomas depressivos nos adolescentes, este Programa deve ser implantado nas escolas em larga escala. Mansour et al (2020) realizaram um estudo com o objetivo de introduzir um projeto baseado no questionário relacionado à saúde mental para monitorar os casos de depressão entre os adolescentes atendidos no Centro de Saúde Federal Qualificado. Os autores inferiram que, após a instauração do projeto, houve um aumento exponencial no que tange tanto ao número de triagens desenvolvidas quanto ao encaminhamento de adolescentes para os serviços de saúde mental.…”

The increases of cognitive impairment, depression level, and physical inactivity in Thai adolescents with obese type 2

“…The PHQ-A scores can be classified as minimal (PHQ-A scores ≤4), mild (PHQ-A scores 5-9), moderate (PHQ-A scores 10-14), moderately severe (PHQ-A scores [15][16][17][18][19] and severe depression (PHQ-A scores 20-27). 26…”