Improving Depression Screening for Adolescents With Type 1 Diabetes
Improving Depression Screening for Adolescents With Type 1 Diabetes
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DOI：
10.1542/peds.2013-0681
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发表时间：
2013-11-01
期刊：
影响因子：
8
通讯作者：
Hood, Korey K.
中科院分区：
文献类型：
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作者：
Corathers, Sarah D.;Kichler, Jessica;Hood, Korey K.
目的：抑郁症在青少年中很常见，但在慢性健康状况下，抑郁症的发病率会显著增加。门诊筛查抑郁症的建议，但很少正式进行，由于实施barrieration.METHODS：为了提供一个模型，抑郁症筛查的青少年慢性健康状况，一个标准的过程中，使用自我管理的电子版本的儿童抑郁量表（CDI）的开发。质量改进的方法和传统的分析方法被用来测试的可行性和结果的常规筛查患者13至17岁的1型diabetes.RESULTS：在528个合格的青少年，509（96%）在第一年接受至少1抑郁症屏幕。该过程在超过1200例患者中进行了测试和改进，结果发现8%的样本的抑郁症筛查率从= 16提高到了= 16; 12%的样本得分中等（10-15）。80%的样本的风险评分为低。较高的CDI评分与较低的血糖监测频率和较高的血红蛋白A1 c相关，证实了更多的抑郁症状与较差的糖尿病管理和控制之间的联系。自杀意念是赞同在7%的population.CONCLUSIONS：系统的抑郁症筛查青少年1型糖尿病可以可靠地实施与临床显着的结果。系统的方法，如本研究所述，可以作为其他慢性健康状况的模型。
OBJECTIVE: Depression is common among adolescents, but rates increase significantly in the presence of chronic health conditions. Outpatient screening for depression is recommended but rarely formally conducted due to barriers of implementation.METHODS: To provide a model for depression screening of youth with chronic health conditions, a standard process using a self-administered electronic version of the Children's Depression Inventory (CDI) was developed. Quality improvement methodology and traditional analytic approaches were used to test the feasibility and outcomes of routine screening in patients 13 to 17 years of age with type 1 diabetes.RESULTS: Of the 528 eligible adolescents, 509 (96%) received at least 1 depression screen during the first year. The process was tested and refined in over 1200 patient encounters, which resulted in an increase in depression screening rates from = 16) were found in 8% of the sample; moderate scores (10-15) in 12% of the sample. Low risk scores were found in 80% of the sample. Higher CDI scores correlated with lower blood glucose monitoring frequency and higher hemoglobin A1c, confirming the link between more depression symptoms and poorer diabetes management and control. Suicidal ideation was endorsed in 7% of the population.CONCLUSIONS: Systematic depression screening in adolescents with type 1 diabetes can be reliably implemented with clinically significant results. A systematic approach, such as described in this study, can serve as a model for other chronic health conditions.