Patient-Administered Screening Tool May Improve Detection and Diagnosis of Depression Among Adolescents

Depression among adolescents is underdiagnosed and associated with significant morbidity and mortality. The American Academy of Pediatrics endorses opportunistic depression screening beginning at age 11, implying that screening should be performed at every visit. The purpose of this quality improvement project was to determine whether a self-administered depression screen would improve the identification of major depressive disorder among adolescents in a pediatric primary care clinic. Introduction of the Patient Health Questionnaire modified for adolescents into a practice with no formal depression screening protocol in place demonstrated an increase in depression diagnosis. Additionally, adolescents presenting for sick visits were more likely to endorse depressive symptoms than those presenting for well visits. These data suggest that administering a patient-administered depression screening tool to adolescents during both well and sick visits will help improve the identification of depression, potentially leading to early diagnosis and improved patient outcomes.