Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Siu, Albert L.; Bibbins‐Domingo, Kirsten; Grossman, David C.; Baumann, Linda C.; Davidson, Karina W.; Ebell, Mark H.; García, Francisco; Gillman, Matthew W.; Herzstein, Jessica; Kemper, Alex R.; Krist, Alex H.; Kurth, Ann; Owens, Douglas K; Phillips, William R.; Phipps, Maureen G.; Pignone, Michael

doi:10.1542/peds.2015-4467

Cited by 269 publications

(312 citation statements)

References 17 publications

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“…Direct evidence indicates that screening may reduce the prevalence of depression in a specific population, particularly when additional support for treatment is available (e.g., treatment guidelines, care management, and availability of trained depression care providers). 5 The USPSTF does not consider the costs of providing a service in this assessment, but notes that persons with chronic illnesses, such as diabetes, are at increased risk of developing depression. Effective care for depression in patients with diabetes is challenging.…”

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confidence: 99%

Costs of Coexisting Depression and Diabetes

Bogner

McClintock

2016

J GEN INTERN MED

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A ccording to the Global Burden of Disease Study 2010 and the World Health Organization, diabetes and depression are leading causes of disability. In the United States, approximately 25.6 million adults have diabetes mellitus (11.3 % of the population). The burden of diabetes is anticipated to grow, with estimates suggesting that the proportion of the population affected by diabetes and related costs will at least double in the next 25 years, yet the proportion of adults whose diabetes is controlled is decreasing over time and is particularly low among older adults and ethnic minorities. Depression is a risk factor for diabetes and risk of depression is increased by a factor of two in patients with diabetes. Depressive symptoms contribute to poor patient engagement, poor adherence to medication and dietary regimens, poor glycemic control, reduced quality of life, and increased health expenditures. 1The influence of depression on outcomes for diabetes includes both biological mechanisms such as increased inflammation, poor self-care, and decreased adherence to treatment regimens. For patients with diabetes, depression has been specifically linked to prognostic variables such as microvascular and macrovascular complications.2 Depression has been found to increase all-cause mortality even in the context of good glucose control.3 For diabetes, increasing attention has been given to the principle that day-to-day management should be in the hands of patients themselves. Self-care activities (e.g., checking one's own finger-stick blood sugar), health behaviors (e.g., smoking, alcohol use, diet, physical activity), and patient choice (e.g., whether to start a new medication or undergo a procedure) all profoundly affect outcomes in diabetes and all are strongly influenced by depression. The biological, social, psychological, and behavioral links between depression and diabetes provide a strong incentive to examine the healthcare costs of depression in adults with diabetes. Moreover, national estimates of the healthcare costs of comorbid depression and diabetes are essential for providing decision makers with needed information to inform policy and practice changes.In this issue of JGIM, Egede et al. 4 investigate the trends in healthcare costs over 8 years in patients aged 18 years and older with diabetes. Based on International Classification of Diseases, Clinical Modification (ICD-9-CM) codes to measure the presence or absence of a depression diagnosis and the two-item Patient Health Questionnaire (PHQ-2) to measure the presence or absence of depressive symptoms, patients with diabetes were classified as no depression, unrecognized depression, asymptomatic depression, or symptomatic depression. The authors report that patients with unrecognized and asymptomatic depression had healthcare expenditures that were $2000-$3000 higher compared to patients with no depression, and patients with symptomatic depression had healthcare expenditures that were $5000 higher compared to patients with no depression after adjustment for ...

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confidence: 99%

Costs of Coexisting Depression and Diabetes

Bogner

McClintock

2016

J GEN INTERN MED

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“…MDD is defined as one or more episodes of 2 weeks of depressive symptoms (for example, changes in appetite, disrupted sleep, or loss of interest or concentration) that affect social, academic, and work performance. 5 Children and teenagers with depression may also use alcohol and drugs, manifest or develop other illnesses, and/or become sexually active.…”

Section: Depressionmentioning

confidence: 99%

“…5,6 There is a high cost for treatment of depression, and unfortunately only about 20% of affected adolescents receive care. 6 Like other chronic diseases, early diagnosis, treatment, and education improve outcomes.…”

Section: Depressionmentioning

confidence: 99%

“…6 The tools most commonly used are the Patient Health Questionnaire for Adolescents (PHQ-A) and the Beck Depression Inventory (BDI). 5 The PHQ-A has a higher predictive value for depression. or gender neutral have a higher rate of suicidal ideation than their peers.…”

Section: Depressionmentioning

confidence: 99%

“…Selective serotonin reuptake inhibitors (SSRIs) are the preferred medication for depression treatment. 5,7 The pediatrician should be familiar with one or two specific SSRI medications. The "black-box warnings" regarding the use of SSRIs and increased suicide risk in 2004 resulted in a sharp decline in these medications being prescribed; 7 however, another detailed in Shain 7 showed that few suicides correlated with the use of SSRIs.…”

Section: Depressionmentioning

confidence: 99%

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Pediatricians as Psychiatrists

Traisman¹

2016

Pediatr Ann

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The overall health of children and teenagers is dependent on their physical and psychological health. As pediatricians, it is important to enquire about the mental health of children and adolescents at the well-child visit. Screening for depression and attention-deficit/hyperactivity disorder is an important component of that visit. Understanding these disorders and the long-term effects on both the child and family as well as managing psychotherapeutic and pharmacological treatments are now becoming a critical part of pediatric care for children and adolescents. [Pediatr Ann. 2016;45(12):e408-e411.]

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Screening for Speech and Language Delay and Disorders in Children

Barry,

Nicholson,

Silverstein

et al. 2024

JAMA

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ImportanceSpeech and language delays and disorders can pose significant problems for children and their families. Evidence suggests that school-aged children with speech or language delays may be at increased risk of learning and literacy disabilities, including difficulties with reading and writing.ObjectiveThe US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening for speech and language delay and disorders in children 5 years or younger.PopulationAsymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development.Evidence AssessmentThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children who do not present with signs or symptoms or parent/caregiver concerns.RecommendationThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms. (I statement)

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Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Cited by 269 publications

References 17 publications

Costs of Coexisting Depression and Diabetes

Costs of Coexisting Depression and Diabetes

Pediatricians as Psychiatrists

Screening for Speech and Language Delay and Disorders in Children

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