Identifying Adolescent Suicide Risk via Depression Screening in Pediatric Primary Care: An Electronic Health Record Review.
Identifying Adolescent Suicide Risk via Depression Screening in Pediatric Primary Care: An Electronic Health Record Review.
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DOI：
10.1176/appi.ps.202000207
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发表时间：
2021-02-01
期刊：
影响因子：
--
通讯作者：
Young JF
中科院分区：
文献类型：
--
作者：
Davis M;Rio V;Farley AM;Bush ML;Beidas RS;Young JF
本研究旨在了解通过在大型儿科初级保健系统中进行的抑郁筛查检测到的自杀风险率，以及青少年认可自杀风险后一年的随访护理。回顾性电子健康记录数据提取用于检查12，690名青少年（12-18岁）在抑郁症筛查当天的自杀风险率和初级保健提供者的随访评估。在过去一个月内，对643名赞同终身自杀企图和/或严重自杀意念的青少年中，对150名青少年的分层随机子样本进行手动图表审查，以深入了解这些高危青少年接受的后续护理。对各种后续行动的图表进行了编码（例如，转介给行为健康提供者，提供危机热线信息）。在完整的筛选样本中，5%的青少年赞同死亡和/或自我伤害的想法，4%的青少年报告了一生的自杀企图，2%的青少年在过去一个月内赞同严重的自杀意念。系统的自杀评估问题有很高的保真度。在自杀风险认可后的一年中，随访护理的变化更大。研究结果表明，将自杀评估程序纳入儿童初级保健抑郁症筛查的可行性，并强调最大限度地预防青少年自杀风险的途径。
This study aims to understand suicide risk rates detected via a depression screener administered across a large pediatric primary care system, as well as follow-up care in the year after adolescents’ endorsement of suicide risk. Retrospective electronic health record data extraction was used to examine rates of suicide risk and primary care providers’ follow-up assessment on the day of depression screening among 12,690 adolescents (ages 12–18). Of the 643 adolescents who endorsed a lifetime suicide attempt and/or serious suicidal ideation in the past month, manual chart review was conducted for a stratified random subsample of 150 adolescents to gain an in-depth understanding of the follow-up care these at-risk adolescents received. Charts were coded for a variety of follow-up actions (e.g., referral to behavioral health providers, provision of crisis line information) in the year following endorsement of suicidality. In the full screening sample, 5% of adolescents endorsed thoughts of death and/or self-harm, 4% reported a lifetime suicide attempt, and 2% endorsed serious suicidal ideation within the past month. There was high fidelity to the system’s suicide assessment questions. Follow-up care during the year after suicide risk endorsement was more variable. Findings demonstrate the feasibility of incorporating suicide assessment procedures into depression screening in pediatric primary care and highlight avenues for maximizing preventative care for adolescents at risk for suicide.
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影响因子：
26.1
作者：
O'Connor, Briannon C.;Lewandowski, R. Eric;Scholle, Sarah Hudson
通讯作者：
Scholle, Sarah Hudson
影响因子：
39.2
作者：
LeFevre, Michael L.
通讯作者：
LeFevre, Michael L.
DOI：
10.1097/00004583-200001000-00014
发表时间：
2000-01-01
影响因子：
13.3
作者：
Shaffer, D;Fisher, P;Schwab-Stone, ME
通讯作者：
Schwab-Stone, ME
影响因子：
5.7
作者：
Ahmedani, Brian K.;Simon, Gregory E.;Solberg, Leif I.
通讯作者：
Solberg, Leif I.
影响因子：
25.8
作者：
Nock, Matthew K.;Green, Jennifer Greif;Hwang, Irving;McLaughlin, Katie A.;Sampson, Nancy A.;Zaslavsky, Alan M.;Kessler, Ronald C.
通讯作者：
Kessler, Ronald C.