Improving depression screening for adolescents with type 1 diabetes

Area of Science:

• Adolescent medicine
• Psychiatry
• Quality improvement science

Background:

• Adolescent depression is prevalent, especially in those with chronic health conditions.
• Current outpatient screening for depression in youth is often not formally implemented due to practical barriers.

Purpose of the Study:

• To develop and test a model for systematic depression screening in adolescents with type 1 diabetes.
• To assess the feasibility, outcomes, and patient/staff acceptance of routine electronic screening.

Main Methods:

• A standard screening process using an electronic Children's Depression Inventory (CDI) was developed.
• Quality improvement and analytic methods were used to evaluate screening in patients aged 13–17 with type 1 diabetes.

Main Results:

• Screening rates increased from <5% to a median of 85% within 12 months, with 96% of eligible adolescents screened.
• Elevated CDI scores were found in 8% of patients, moderate scores in 12%, and 80% had low risk scores.
• Higher depression scores correlated with poorer diabetes control (lower blood glucose monitoring, higher HbA1c); 7% endorsed suicidal ideation.

Conclusions:

• Systematic depression screening is reliably implementable in adolescents with type 1 diabetes, yielding clinically significant results.
• This systematic approach can serve as a model for screening in other chronic pediatric health conditions.