Screening for adolescent depression in a pediatric emergency department.
OBJECTIVE
To describe the prevalence of depressive symptoms in adolescents presenting to the emergency department (ED) and to describe their demographics and outcomes compared with adolescents endorsing low levels of depressive symptoms.


METHODS
The Beck Depression Inventory-2nd edition (BDI-II) was used to screen all patients 13-19 years of age who presented to the ED during the period of study. The BDI-II is a 21-item self-report instrument used to measure the presence and severity of depressive symptoms in adolescents and adults. Demographics and clinical outcomes of screening-program participants were abstracted by chart review. Patients were categorized into one of four severity categories (minimal, mild, moderate, or severe) and one of three presenting complaint categories (medical, trauma, mental health).


RESULTS
Four hundred eighty-seven patients were approached, and 351(72%) completed the screening protocol. Participants endorsed minimal (n = 192, 55%), mild (n = 52, 15%), moderate (n = 41, 11%), or severe depressive symptoms (n = 66, 19%). Those with moderate or severe depressive symptoms were more likely to be hospitalized. Of patients completing the BDI-II, 72% with psychiatric, 12% with traumatic, and 19% with medical chief complaints endorsed either moderate or severe depressive symptoms.


CONCLUSIONS
Depressive symptoms are prevalent in this screening sample, regardless of presenting complaint. A substantial proportion of patients with nonpsychiatric chief complaints endorsed moderate or severe depressive symptoms. A screening program might allow earlier identification and referral of patients at risk for depression.
Department of Pediatrics, Akron Children's Hospital, Akron, OH 44308, USA. eg@neoucom.edu
Emily Gale
EG
Scott
Brett
B
Luxmore
Heather
H
Alexander
Robin L
RL
Fenn
Norman C
NC
Christopher
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000706:statistics & numerical data*; D009820:Ohio / Q000453:epidemiology; D010358:Patient Participation / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology