To 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 prior to pediatric well child visits.
A total of 9.9% (n=535) patients 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. 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.