Summary: Authors compare the use of the
parent-report Pediatric Symptom Checklist (PSC-17P) and youth-report Patient
Health Questionnaire-9 Modified for Teens (PHQ-9M) in compliance with recent
quality standards for adolescent depression screening.
Parents of 5,411
pediatric outpatients (11.0–17.9 years old) completed the PSC-17P, which
contains scales that assign categorical risk for overall (PSC-17P-OVR),
internalizing (PSC-17P-INT), externalizing (PSC-17P-EXT), and attention
(PSC-17P-ATT) problems. Adolescents completed the PHQ-9M, which assesses
depressive symptoms. Both forms were completed online within 24 hours of each
other before pediatric well-child visits.
Findings: A total of
9.9% of patients (n = 535) were at risk on the PSC-17P-OVR, 14.3%
(n = 775) were at risk on the PSC-17P-INT, and 17.0%
(n = 992) were at risk on either or both scales (PSC-17P-OVR and/or
PSC-17P-INT). Using the PHQ-9M cut-off score of 10 (moderate-very severe
depression), an additional 2.4% (n = 131) were classified as at risk,
with 66.8% (n = 263) of all PHQ-9M positives (n = 394) also
coded as at risk by the PSC-17P-OVR and/or PSC-17P-INT scales. Using a PHQ-9M
cut-off score of 15 (severe-very severe depression), only 29 patients (21.8% of
the PHQ-9M positives) not identified by the PSC-17P-OVR and/or PSC-17P-INT were
classified as being at risk.
The combined
PSC-17P-OVR and/or PSC-17P-INT scales identified 17% of adolescents as at risk
for depression, including about two-thirds to three-quarters of adolescents
classified as at risk on the PHQ-9M. These findings support using the PSC-17P
to meet quality standards for depression as well as overall screening in
pediatrics. Primary care clinicians can add the PHQ-9M to identify additional
adolescents who may self-report depressive symptoms.