Faculty Collaboration Database

Clinical associations of quarterly Patient Health Questionnaire-9 depression screening results in adolescents with type 1 diabetes. Pediatr Diabetes 2020 Aug;21(5):871-877

Date

04/12/2020

Pubmed ID

32277561

DOI

10.1111/pedi.13017

Scopus ID

2-s2.0-85083696981 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: Awareness of comorbid depression in type 1 diabetes (T1D) patients is necessary to optimize health and diabetes care. Depression can occur or recur requiring regular review for depression symptoms. A validated tool to screen adolescents for symptoms of depression is the Patient Health Questionnaire (PHQ)-9 Modified for Teens (PHQ9^1-9 ).

METHODS: PHQ9^1-9 depression screen results, depression-related ICD-codes, demographic data, and information on complications and comorbidities of adolescents ≥11 years old with T1D were obtained. Longitudinal and single observation multivariable analyses identified associations of covariates with positive PHQ9^1-9 depression screens.

RESULTS: 5032 PHQ9^1-9 surveys were completed by 1225 unique participants. Overall, 6% (286/5032) of the PHQ9^1-9 depression screens were positive, and 60% (171/286) of the positive screens occurred in 107 unique patients without documented depression. In the longitudinal analysis, positive PHQ9^1-9 screens were associated (P < .05) with a diagnosis of depression listed in the medical record (OR 9.8), diabetic retinopathy (OR 4.3), female sex (OR 1.9), and use of an insulin pump (OR 0.5), while the single observation analysis at the time of a positive PHQ9^1-9 indicated presence of depression in the medical record (odds ratio 12.1), female sex (OR 1.9), and obesity (OR 1.8) were significantly (P < .05) associated with positive PHQ9^1-9 results.

CONCLUSION: Quarterly PHQ9^1-9 depression screening of adolescents with T1D during routine clinic visits can immediately inform care, and previous diagnosis of depression is the most strongly associated covariate, highlighting the importance of documenting depression in the medical record. Additionally, awareness for higher odds of positive PHQ9^1-9 depression screens in females, obese adolescent, and patients on insulin injections is important.

Author List

Wolfgram P, Zhang L, Simpson P, Fiallo-Scharer R

Authors

Rosanna V. Fiallo-Scharer MD Professor in the Pediatrics department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Peter M. Wolfgram MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Factors
Child
Comorbidity
Depression
Diabetes Mellitus, Type 1
Female
Humans
Longitudinal Studies
Male
Mass Screening
Patient Health Questionnaire
Psychology, Adolescent
United States