Comparison of Adolescent Depression Screening Using Orally Administered Versus Written Self-Report Scores.

Abstract

Objective: The objective of our retrospective study was to evaluate differences between screening methods (oral administration versus written self-report) for adolescent depression in an outpatient settingStudy Design:We analyzed data from 4075 well-child check (WCC) visits from adolescents (ages 12-18 years) at an academic medical center from January 2022 through December 2023. We evaluated the outcomes of depression screening questions from both those asked by staff (oral administration) and those filled out on paper by the patient (written self-report). A composite score of 3 or greater (out of 6) indicates a positive screen for depression. Logistic regression was used to assess for the likelihood of discrepancy between scores.

Results: Of the 4518 WCC visits analyzed, 3380 (75%) had completed data for both the orally administered and the written screenings. The scores were equal in 2563 (76%) visits; the written score was greater in 766 (22.6%) visits and the oral score was greater in 51 (1.5%) visits. The screen was positive for depression in 232 (6.8%) visits for the written self-report compared with 66 (2.0%) from the oral administration. Logistic regression analyses showed likelihood of score differences were higher in older age, female gender, Hispanic race/ethnicity, and those with public insurance.

Conclusion: This preliminary pilot study shows that there are score differences in depression screening when administered orally by staff versus self-reported in writing, and scores may be higher on the written self-report screening. Limitations of this study include slight differences in the wording of the questions and lack of rigorous protocol guidelines.