title: What clinical differences distinguish depressed teens with and without comorbid externalizing problems?
abstract: OBJECTIVE
  This study examined differences in co-occurring symptoms, psychosocial correlates, health care utilization and functional impairment in youth who screened positive for depression, stratified by whether or not they also self-reported externalizing problems.
  
  
  METHODS
  The AdoleSCent Health Study examined a random sample of youth ages 13-17 enrolled in a health care system. A total of 2291 youth (60.7% of the eligible sample) completed a brief depression screen: the two-item Patient Health Questionnaire. The current analyses focus on a subset of youth (n=113) who had a follow-up interview and screened positive for possible depression on the Patient Health Questionnaire 9 using a cutoff score of 11 or higher [1]. Youth were categorized as having externalizing behavior if their score was ≥ 7 on the Pediatric Symptom Checklist (PSC) externalizing scale [2,3]. χ(2) tests and Wilcoxon rank sum tests were used to compare groups.
  
  
  RESULTS
  Differences between groups included that youth with depression and externalizing symptoms had a higher rate of obesity and had higher self-reported functional impairment than youth with depression symptoms alone.
  
  
  CONCLUSIONS
  Adding screening for externalizing problems to existing recommendations for depression screening may help primary care providers to identify a high-risk depressed group of youth for referral to mental health services.
authors: Department of Psychiatry, University of Washington, Seattle Children's Hospital, Seattle, WA 98195, USA. rockhill@u.washington.edu
authors: Carol M
authors: CM
authors: Rockhill
authors: Wayne
authors: W
authors: Katon
authors: Julie
authors: J
authors: Richards
authors: Elizabeth
authors: E
authors: McCauley
authors: Carolyn A
authors: CA
authors: McCarty
authors: Mon T
authors: MT
authors: Myaing
authors: Chuan
authors: C
authors: Zhou
authors: Laura P
authors: LP
authors: Richardson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016022:Case-Control Studies; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services; D009765:Obesity / Q000453:epidemiology; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index
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