Adolescent depression screening in primary care: feasibility and acceptability.
OBJECTIVE
Despite available depression treatments, only one fourth to one third of depressed adolescents are receiving care. The problem of underdiagnosis and underreferral might be redressed if assessment of suicidality and depression became a more formal part of routine pediatric care. Our purpose for this study was to explore the feasibility and acceptability of implementing adolescent depression screening into clinical practice.


METHODS
In this study we implemented a 2-stage adolescent identification protocol, a first-stage pen-and-paper screen and a second-stage computerized assessment, into a busy primary care pediatric practice. Providers tracked the number of eligible patients screened at both health maintenance and urgent care visits and provided survey responses regarding the burden that screening placed on the practice and the effect on patient/parent-provider relationships.


RESULTS
Seventy-nine percent of adolescent patients presenting for health maintenance visits were screened, as were the majority of patients presenting for any type of visit. The average completion time for the paper screen was 4.6 minutes. Providers perceived parents and patients as expressing more satisfaction than dissatisfaction with the screening procedures and that the increased time burden could be handled. All providers wished to continue using the paper screen at the conclusion of the protocol.


CONCLUSIONS
Instituting universal systematic depression screening in a practice with a standardized screening instrument met with little resistance by patients and parents and was well perceived and accepted by providers.
Zuckerbrot
Rachel A
RA
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, New York, New York, USA. raz1@columbia.edu
Maxon
Laura
L
Pagar
Dana
D
Davies
Mark
M
Fisher
Prudence W
PW
Shaffer
David
D
D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011594:Psychometrics