Multistage Adolescent Depression Screening: A Comparison of 11-Year-Olds to 12-Year-Olds

Cortez, Alan B; Wilkins, Julia; Handler, Eric G.; Lerner, Marc; Burchette, Raoul J.; Wissow, Lawrence S.

doi:10.7812/tpp/20.233

Cited by 3 publications

(3 citation statements)

References 59 publications

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“…Additionally, the results might not translate to clinicians who care only for children, since the GPs’ attention to parents might have played a role in children’s improvement. Conversely, had screening been a routine clinical practice within the collaborative, detection rates and child outcomes might have been better …”

Section: Discussionmentioning

confidence: 99%

“…Conversely, had screening been a routine clinical practice within the collaborative, detection rates and child outcomes might have been better. 36 Strengths include enrolling a relatively large number of clinicians of a type commonly providing primary care in countries across the income spectrum 37,38 and demonstrating an impact on a heterogeneous population of children. We were also able to document improvements despite living conditions that worsened markedly during the study.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

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Effect of General Practitioner Training in a Collaborative Child Mental Health Care Program on Children’s Mental Health Outcomes in a Low-Resource Setting

et al. 2023

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ImportanceIntegrated care for children is rarely studied, especially in low- and middle-income countries, where generalists often provide mental health care.ObjectivesTo explore the effect of adding a child and youth component to an existing adult collaborative care program on mental health outcomes and receipt of care.Design, Setting, and ParticipantsThis cluster randomized trial was conducted within an adult collaborative care program in Tehran, Iran. General practitioners (GPs), their 5- to 15-year-old patients, and patients’ parents were included. Children and youths coming for routine medical visits who scored greater than the cutoff on the Strengths and Difficulties Questionnaire (SDQ) were followed up for 6 months. The study was conducted from May 2018 to October 2019, and analysis was conducted from March 2020 to August 2021.InterventionsGPs were randomized to either a 2.5-day training on managing common child mental health problems (intervention) or refresher training on identification and referral (control).Main Outcomes and MeasuresPrimary outcome was change in SDQ total problems score; secondary outcomes included discussion of psychosocial issues by the GPs and receipt of mental health care during the follow-up period.ResultsOverall, 49 GPs cared for 389 children who scored greater than the cutoff on the SDQ (216 children in intervention group, 173 in control group). Patients’ mean (SD) age was 8.9 (2.9) years (range, 5 to 15 years), and 182 (47%) were female patients. At 6 months, children in the intervention group had greater odds of receiving mental health care during the study (odds ratio [OR], 3.0; 95% CI, 1.1 to 7.7), parents were more likely to report that intervention GPs had discussed parent (OR, 2.1; 95% Cl, 1.1 to 3.8) and child (OR, 2.0; 95% Cl, 0.9 to 4.8) psychosocial issues, and intervention GPs were more likely to say they had provided counseling (OR, 1.8; 95% Cl, 1.02 to 3.3). However, there was no greater improvement in SDQ scores among children seen by intervention vs control GPs. Adjusted for clustering within GP, the variables used for balanced allocation (practice size, practice ownership, and study wave), and the other variables associated with change in SDQ scores over time, there was not a significant time-treatment interaction at either the 3- or 6-month follow-up points (linear combination of coefficients for intervention, 0.57 [95% CI, –1.07 to 2.22] and –0.08 [95%CI, –1.76 to 1.56], respectively). In a subgroup of GPs with practices composed of 50% or more children, children seen by intervention GPs improved to a significantly greater extent (–3.6 points; 95% CI, –6.7 to –0.46 points; effect size d = 0.66; 95% CI, 0.30 to 1.01) compared with those seen by control GPs.Conclusions and RelevanceIn this cluster randomized trial, GP training on managing common child mental health problems did not demonstrate greater improvement in child SDQ scores. Child mental health training for GPs in collaborative care can improve children’s access to mental health care, but prior experience working with children and their families may be required for GPs to use a brief training in a way that improves child outcomes.Trial RegistrationClinicalTrials.gov Identifier: NCT03144739

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Section: Discussionmentioning

confidence: 99%

Section: Limitations and Strengthsmentioning

confidence: 99%

Effect of General Practitioner Training in a Collaborative Child Mental Health Care Program on Children’s Mental Health Outcomes in a Low-Resource Setting

et al. 2023

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“…This guideline also appears to folow the United States Preventative Task Force’s (2022) determination that there is insufficient evidence to warrant depression screenings at a younger age. In terms of assessments, one study utilizing the PHQ-9A documented no significant differences in completion, mean total scores, or rates of positive screenings that would affect or preclude its use among 11-year-olds ( Cortez et al 2021 ). That study opted to use the adolescent modified versions of the scales (for use among 11–17-year-olds) in light of their established reliability in cross-cultural settings ( Aggarwal et al, 2017 ; Burdzovic Andreas & Brunborg, 2017 ; Naveed et al, 2019 ; Yalın Sapmaz et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

Depression and anxiety among multiethnic middle school students: Age, gender, and sociocultural environment

Jenkins

Sánchez

Miller

et al. 2022

Int J Soc Psychiatry

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Background: Depression and anxiety-related disorders are common among adolescents. Research attention to early adolescence and low-income ethnically diverse populations is limited. Aim: To conduct screening for depression and anxiety at an early age with attention to gender and socioenvironmental context within a low-income setting. Method: Mixed methods included the PHQ-9A and GAD-10 screening instruments and ethnographic interviews. Results: 75 ethnically diverse middle school students were included. Mean years age was 11.2 (0.74). Females had higher PHQ-9A sum scores than males ( p = .002, Mann-Whitney test) and higher GAD-10 sum scores than males ( p = .016, Mann-Whitney test). After controlling for multiple comparisons, girls had higher mean responses on three PHQ-9A items ( p < .006, two-sided t-test) and only one GAD-10 item ( p < .005, two-sided t-test). Ethnographic interviews revealed contexts associated with girls’ experiences of depression and anxiety, including gender-based violence in both school and home environments. Salient for girls and boys alike were worries about consequences of COVID-19 for family with respect to illness, death, job loss, economic hardship. Fears over student perceptions of intensified discrimination and racism in school and community were prominent. These problems were experienced by students as barriers to educational engagement. Conclusion: Specific attention to early adolescence is needed to identify emergence of subsyndromal conditions which may benefit from therapeutic attention to reduce symptom severity, identify sociocultural, structural, and gender-specific stressors, and to enhance educational engagement.

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Trends in Adolescent Depression Screening Outcomes Over the COVID-19 Pandemic at a Large, Integrated Health Care System in Southern California

Tsai,

Kozman,

Becker

et al. 2024

Journal of Adolescent Health

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Multistage Adolescent Depression Screening: A Comparison of 11-Year-Olds to 12-Year-Olds

Cited by 3 publications

References 59 publications

Effect of General Practitioner Training in a Collaborative Child Mental Health Care Program on Children’s Mental Health Outcomes in a Low-Resource Setting

Effect of General Practitioner Training in a Collaborative Child Mental Health Care Program on Children’s Mental Health Outcomes in a Low-Resource Setting

Depression and anxiety among multiethnic middle school students: Age, gender, and sociocultural environment

Trends in Adolescent Depression Screening Outcomes Over the COVID-19 Pandemic at a Large, Integrated Health Care System in Southern California

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