Diagnoses and Treatment After Depression Screening in Primary Care Among Youth.
Diagnoses and Treatment After Depression Screening in Primary Care Among Youth.
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DOI：
10.1016/j.amepre.2021.09.008
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发表时间：
2022-04
影响因子：
5.5
通讯作者：
Mojtabai R
中科院分区：
文献类型：
--
作者：
Riehm KE;Brignone E;Stuart EA;Gallo JJ;Mojtabai R
在美国，抑郁症筛查被普遍推荐给在初级保健机构就诊的青少年。然而，随着时间的推移，抑郁症筛查如何影响被诊断为精神障碍或获得精神保健的可能性，人们知之甚少。这项纵向队列研究使用了2014年至2017年期间参加油井访问的青少年的保险索赔数据。倾向评分匹配用于比较接受抑郁症筛查的青少年和类似的未接受筛查的青少年。在6个月的随访中，研究人员检查了诊断和治疗情况，包括抑郁症诊断、情绪相关诊断、抗抑郁药物、任何精神健康药物和心理治疗。性别间关联的异质性也被检验。分析时间为2020年12月至2021年6月。样本包括57,732名青少年（平均年龄14.26岁，女性48.9%）。与未接受抑郁症筛查的青少年相比，接受抑郁症筛查的青少年被诊断为抑郁症的可能性高出30%（风险比[RR]=1.30, 95% CI=1.11, 1.52），接受情绪相关诊断的可能性高出17% (RR=1.17, 95% CI=1.08, 1.27)，但接受抗抑郁药物治疗（RR=1.11, 95% CI=0.82, 1.51）、任何精神健康药物治疗（RR=1.15, 95% CI=0.87, 1.53）或心理治疗（RR=1.13, 95% CI=0.98, 1.31）的可能性并不高。这种关联在女性青少年中普遍更强。在健康访问中接受抑郁症筛查的青少年更有可能在筛查后的6个月内被诊断为抑郁症或情绪相关障碍。未来的研究应探索在筛查后增加治疗吸收的方法。
Depression screening is universally recommended for adolescents presenting in primary care settings in the U.S. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time. This longitudinal cohort study used insurance claims data from adolescents who attended a well-visit between 2014 and 2017. Propensity score matching was used to compare adolescents who were screened for depression to similar unscreened adolescents. Diagnoses and treatment uptake were examined over 6-month follow-up and included depression diagnoses, mood-related diagnoses, antidepressant medications, any mental health medication, and psychotherapy. Heterogeneity of associations by sex was also examined. Analyses were conducted from December 2020 to June 2021. The sample included 57,732 adolescents (mean age of 14.26 years, 48.9% female). Compared with adolescents who were not screened for depression, adolescents screened for depression were 30% more likely to be diagnosed with depression (risk ratio [RR]=1.30, 95% CI=1.11, 1.52) and 17% more likely to receive a mood-related diagnosis (RR=1.17, 95% CI=1.08, 1.27), but were not more likely to be treated with an antidepressant medication (RR=1.11, 95% CI=0.82, 1.51), any mental health medication (RR=1.15, 95% CI=0.87, 1.53), or psychotherapy (RR=1.13, 95% CI=0.98, 1.31). Associations were generally stronger among female adolescents. Adolescents who were screened for depression during a well-visit were more likely to receive a diagnosis of depression or a mood-related disorder in the 6 months following screening. Future research should explore methods for increasing treatment uptake following screening.
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DOI：
10.1176/appi.ps.202000207
发表时间：
2021-02-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Davis M;Rio V;Farley AM;Bush ML;Beidas RS;Young JF
通讯作者：
Young JF
影响因子：
3.7
作者：
Badawy, Sherif M.;Radovic, Ana
通讯作者：
Radovic, Ana
影响因子：
9.7
作者：
BURNS, BJ;COSTELLO, EJ;ERKANLI, A
通讯作者：
ERKANLI, A
影响因子：
2.9
作者：
Brignone E;George DR;Sinoway L;Katz C;Sauder C;Murray A;Gladden R;Kraschnewski JL
通讯作者：
Kraschnewski JL
影响因子：
2.8
作者：
Honigfeld, Lisa;Macary, Susan J.;Grasso, Damion J.
通讯作者：
Grasso, Damion J.