title: Depression screening in adolescents in the United States: a national study of ambulatory office-based practice.
abstract: OBJECTIVE
  To determine the frequency of depression screening during ambulatory, office-based visits for adolescents seen in general/family medicine or pediatric practices in the United States using nationally representative data; to determine the patient-, provider-, and visit-level factors associated with depression screening during ambulatory visits to inform recommendations to promote screening.
  
  
  METHODS
  This cross-sectional study used the 2005-2010 National Ambulatory Medical Care and National Hospital Ambulatory Medical Care Surveys. Data were limited to ambulatory, office-based visits to general/family medicine or pediatrics clinics for adolescents aged 12 to 18 years who did not have a documented diagnosis of depression.
  
  
  RESULTS
  Depression screening was rare (0.2%; 95% confidence interval [CI] 0.1-0.3), and it was 80% less likely to occur during visits for Hispanic compared to non-Hispanic white adolescents (adjusted odds ratio [aOR] 0.2, 95% CI 0.1-0.7). Depression screening was 9.1 times more likely in the Northeast compared to the West (aOR 9.1, 95% CI 2.2-38.1) if there were no visits within past 12 months compared to 6 or more visits (aOR 6.1; 95% CI 1.8-20.4), and if stress management (aOR 24.2, 95% CI 11.8-49.5) or other mental health counseling (aOR 5.2, 95% CI 1.2-23.6) were provided.
  
  
  CONCLUSIONS
  Depression screening for adolescents is rare and is associated with racial/ethnic and regional disparities. The integration of behavioral and mental health services within the patient-centered medical home might assist providers in identifying and treating depression and in addressing such disparities.
authors.affiliation: Division of Endocrinology, Boston Children's Hospital, Boston, Mass. Electronic address: Ian.Zenlea@childrens.harvard.edu.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Zenlea
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Mass.
authors.forename: Carly E
authors.initials: CE
authors.lastname: Milliren
authors.affiliation: Department of Psychology, Boston Children's Hospital, Boston, Mass.
authors.forename: Lauren
authors.initials: L
authors.lastname: Mednick
authors.affiliation: Division of Endocrinology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
authors.forename: Erinn T
authors.initials: ET
authors.lastname: Rhodes
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D044383:Black People / Q000523:psychology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000208:ethnology; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data*; D014481:United States; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D001741:Black or African American
keywords: adolescent depression; adolescents; screening