Real-World Depression Screening Practices Among Primary Care Providers Across Patient-Level and Provider-Level...

Area of Science:

• Adolescent mental health
• Primary care research
• Clinical guideline adherence

Background:

• Adolescent depression is a significant public health concern.
• Primary care settings are crucial for early identification and intervention.
• Guideline-based screening for depression in adolescents is recommended but implementation varies.

Purpose of the Study:

• To assess primary care provider (PCP) alignment with guideline-based adolescent depression screening.
• To identify factors influencing post-screening responses and depression identification.
• To examine disparities in screening follow-up and diagnosis.

Main Methods:

• Retrospective chart review across 17 primary care clinics.
• Analysis of provider specialties, sociodemographic factors, and patient clinical histories.
• Logistic regression models to identify predictors of screening outcomes.

Main Results:

• Significant differences in depression follow-up and identification based on depression severity.
• Follow-up screening was more common in privately insured patients and less common in Black patients.
• History of mental health concerns, psychotropic medication use, or prior referrals increased the likelihood of depression identification.

Conclusions:

• PCPs' adherence to adolescent depression screening guidelines is variable.
• Patient factors, including race and insurance status, are associated with disparities in care.
• Clinical history significantly predicts depression identification, suggesting opportunities for targeted interventions.