Assessment and management of anxiety and depression in a pediatric high‐risk asthma clinic

Abstract

ObjectiveThe aims of this study were to determine the prevalence of positive mental health (MH) screens in a pediatric high‐risk asthma (HRA) clinic population, and to determine the success rate of engagement in MH services before and after adding a clinical psychologist to our multidisciplinary clinic.HypothesisWe hypothesized that the HRA population would have a higher prevalence of anxiety/depression symptoms than that previously reported for the general pediatric asthma population. We anticipated that the presence of an embedded psychologist in HRA clinic would facilitate successful connection to MH services.MethodsPediatric patients in the HRA clinic were prospectively screened for anxiety and depression using validated screening instruments. Positive scores were referred for MH services. Time to MH service engagement was recorded before and after the addition of a clinical psychologist.ResultsA total of 186 patients were screened; 60% had a positive MH screen. Female sex was associated with higher median scores on both screening tools and higher likelihood of engagement in MH services. After addition of a clinical psychologist, new engagement in MH services increased (20% vs. 80%, p < 0.0001), and median time to engagement decreased (14.5 vs. 0.0 months, p = 0.003).ConclusionThere is a high prevalence of anxiety and depression in this pediatric HRA population. Success of engagement in MH services improved after a clinical psychologist joined our multidisciplinary team, suggesting access to care as a primary barrier to engagement.

Pediatric Pulmonology 2023 Year in Review: Asthma

“…Addressing these issues is imperative to improving asthma control. In a retrospective study, researchers from Indiana screened 186 children for depression and anxiety in children with high-risk asthma 4 . 60% had a positive mental health (MH) screen.…”