The clinical utility of the safe times questionnaire

Schubiner, Howard; Tzelepis, Angela; Wright, Kathryn; Podany, Edward C.

doi:10.1016/1054-139x(94)90260-7

Cited by 35 publications

(25 citation statements)

References 24 publications

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“…Trigger questionnaires combined with clinical interviews have been found to increase the accuracy of risk identification in adolescents. 35 Thus, widespread adoption of patient trigger questionnaire use, combined with a strategy of comprehensive preventive counseling, may result in delivery of recommended content. The lack of difference between clinicians who received training in GAPS and those who did not (but who, nonetheless, used the materials in practice) may suggest the importance of trigger questionnaires and other materials in increasing provision of preventive services.…”

Section: Adolescent Receipt Of Carementioning

confidence: 99%

Improving Adolescent Preventive Care in Community Health Centers

Klein¹,

Allan²,

Elster

et al. 2001

Pediatrics

111

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Section: Adolescent Receipt Of Carementioning

confidence: 99%

Improving Adolescent Preventive Care in Community Health Centers

Klein¹,

Allan²,

Elster

et al. 2001

Pediatrics

111

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“…20 Even physicians who are trained in the use of mnemonics to guide interviews underidentify adolescent depression. 28 Instead, only by asking patients directly about depression and suicide (versus relying on them to volunteer the information) does one reliably improve case finding and the psychometric quality of diagnostic data. [29][30][31][32] Using systematic assessment methods with depression-specific questions seems to provide the best identification results.…”

Section: Literature Reviews: Identification and Assessmentmentioning

confidence: 99%

“…[27][28][29]33 Many steps are involved in implementing systematic depression-identification procedures within a busy practice setting (eg, training office staff in the use of procedures, adjusting other paperwork demands to fit the depression-identification procedures, ensuring that providers review the information, teaching providers how to use the information, and determining whether the procedures actually benefit youth). Although no study has documented the feasibility and outcomes of taking all of these steps within a single study, evidence from the review cited above as well as a recently published pilot study, 34 suggests that each of these steps can be implemented in real-world settings (ie, training office staff 27,28,30,[33][34][35][36][37] , ensuring PC providers review any results 27,28,[32][33][34]37 , and establishing that appropriate counseling and/or needed mental health referrals are made 33,39 ). Finally, and perhaps most importantly, although no study compared outcomes between screened and notscreened groups, 1 study did demonstrate that an identification program in PC when combined with highquality depression treatment actually yields better outcomes than treatment-as-usual conditions 8 (when no high-quality depression treatment is available).…”

Section: Literature Reviews: Identification and Assessmentmentioning

confidence: 99%

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

et al. 2007

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OBJECTIVES. To develop clinical practice guidelines to assist primary care clinicians in the management of adolescent depression. This first part of the guidelines addresses identification, assessment, and initial management of adolescent depression in primary care settings.METHODS. By using a combination of evidence-and consensus-based methodologies, guidelines were developed by an expert steering committee in 5 phases, as informed by (1) current scientific evidence (published and unpublished), (2) a series of focus groups, (3) a formal survey, (4) an expert consensus workshop, and (5) draft revision and iteration among members of the steering committee.RESULTS. Guidelines were developed for youth aged 10 to 21 years and correspond to initial phases of adolescent depression management in primary care, including identification of at-risk youth, assessment and diagnosis, and initial management. The strength of each recommendation and its evidence base are summarized. The identification, assessment, and initial management section of the guidelines includes recommendations for (1) identification of depression in youth at high risk, (2) systematic assessment procedures using reliable depression scales, patient and caregiver interviews, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, (3) patient and family psychoeducation, (4) establishing relevant links in the community, and (5) the establishment of a safety plan.CONCLUSIONS. This part of the guidelines is intended to assist primary care clinicians in the identification and initial management of depressed adolescents in an era of great clinical need and a shortage of mental health specialists but cannot replace clinical judgment; these guidelines are not meant to be the sole source of guidance for adolescent depression management. Additional research that addresses the identification and initial management of depressed youth in primary care is needed, including empirical testing of these guidelines. 4,5 Even when diagnosed by PC physicians, only half of these patients are treated appropriately. 3 Furthermore, rates of completion of specialty mental health referral for youth with a recognized emotional disorder from general medical settings are quite low (J. V. Campo, MD, written communication, 2006).In view of the shortage of mental health clinicians and barriers to children having access to mental health professionals, the well-documented need for PC clinicians to learn how to manage this condition, the increasing evidence base available to guide clinical practice, increased selective serotonin reuptake inhibitor-prescribing rates in pediatric PC, 6,7 and new evidence that a multifaceted approach with mental health consultation may improve the management of depression in PC settings, [8][9][10][11] guidelines may be a necessary first step in the identification and management of depression in adolescents in PC. Unfortunately, no depression-management guidelines have been developed for use in the PC setting in the United S...

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“…14, 15 The use of these screening techniques can improve the quality of assessments of depression while reducing the time needed for questioning during routine examinations.…”

Section: Symptoms Of Major Depressive Disorder In Adolescentsmentioning

confidence: 99%