Predicting Adolescent Depression and Suicide Risk Based on Preadolescent Behavioral Health Screening in Primary Care

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-04-15 DOI:10.1016/j.acap.2025.102833

Jason D. Jones PhD , Molly Davis PhD , Sara Reagan BS , Claire Hatkevich PhD , Jan Leonard MSPH , Karen T.G. Schwartz PhD , Jasmine Figueroa MS , Jami F. Young PhD

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引用次数: 0

Abstract

Objective

To examine the degree to which a broadband behavioral health screener administered in preadolescence in primary care (PC) could serve as an early risk indicator for depression and suicide risk in adolescence.

Methods

Participants included 9329 patients who attended well visits at 9 and 12 years old in a large pediatric PC network. The sample was 49% female, 64% White, 18% Black, 4% Asian, 14% other races, and 6% Hispanic/Latinx. Caregivers completed the Pediatric Symptom Checklist (PSC-17) about their child at age 9; youth completed the Patient Health Questionnaire-9 Modified for Teens (PHQ-9-M) at age 12.

Results

After adjusting for demographic covariates, patients scoring above the risk cutoffs on the PSC-17 total scale and subscales (internalizing, externalizing, and attention) at age 9 had significantly greater odds of elevated depression and/or suicide risk on the PHQ-9-M at age 12 (odds ratios: 2.41–4.23, P < .001). Approximately one third of patients with depression (sensitivity: 37.1%) or suicide (sensitivity: 33.3%) risk at age 12 were identified as at risk on the PSC-17 at age 9.

Conclusions

Results suggest that the PSC-17, a well-researched screener widely used in pediatrics, has moderate predictive value with respect to depression and suicide risk during adolescence. More research is needed on the feasibility and potential benefits of broadband behavioral health screening in preadolescence to promote early identification and prevention efforts.

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基于初级保健的青春期前行为健康筛查预测青少年抑郁和自杀风险。

目的：探讨宽带行为健康筛查在青少年前期初级保健（PC）中作为青少年抑郁和自杀风险的早期风险指标的作用。方法：参与者包括9,329名9岁和12岁时在大型儿科PC网络中进行健康访问的患者。样本中女性占49%，白人占64%，黑人占18%，亚洲人占4%，其他种族占14%，西班牙裔/拉丁裔占6%。照顾者在孩子9岁时完成儿童症状检查表（PSC-17）；青少年在12岁时完成了患者健康问卷-9 （PHQ-9-M）。结果：在调整人口统计学协变量后，9岁时PSC-17总量表和亚量表（内在化、外在化和注意力）得分高于风险临界值的患者在12岁时PHQ-9-M抑郁和/或自杀风险升高的几率显著更高（优势比：2.41至4.23）。研究结果表明，PSC-17对青少年抑郁和自杀风险具有中等预测价值。PSC-17是一种广泛应用于儿科研究的筛查方法。需要对青春期前宽带行为健康筛查的可行性和潜在益处进行更多的研究，以促进早期识别和预防工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.