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Screening and management of adolescent depression in a large pediatric care network

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TitleInfo
Title
Screening and management of adolescent depression in a large pediatric care network
Name (type = personal)
NamePart (type = family)
McCarthy
NamePart (type = given)
Alyssa E.
NamePart (type = date)
1990-
DisplayForm
Alyssa E. McCarthy
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Young
NamePart (type = given)
Jami F.
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Jami F. Young
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Chu
NamePart (type = given)
Brian C.
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Brian C. Chu
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Wilson
NamePart (type = given)
G. Terence
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G. Terence Wilson
Affiliation
Advisory Committee
Role
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internal member
Name (type = personal)
NamePart (type = family)
Lewandowski
NamePart (type = given)
R. Eric
DisplayForm
R. Eric Lewandowski
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Graduate Studies
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (encoding = w3cdtf); (keyDate = yes); (qualifier = exact)
2019
DateOther (encoding = w3cdtf); (qualifier = exact); (type = degree)
2019-10
Language
LanguageTerm (authority = ISO 639-3:2007); (type = text)
English
Abstract (type = abstract)
There is low access to adolescent depression care due to lack of identification, a shortage of mental health professionals, and personal and logistical barriers to seeking treatment. Primary care has therefore been promoted as a setting to identify and manage this prevalent and impairing condition.

Data for this study came from electronic health record (EHR) extraction in a large pediatric care network with an organizational recommendation to screen for depression at age 16 well visits using a tablet-based, EHR-integrated version of the Patient Health Questionnaire - Modified for Teens (PHQ-9-M). Analyses examined rates of screening and elevated symptoms during a two-year period. For at-risk patients (those with threshold and subthreshold scores on the PHQ-9-M), analyses explored primary care providers' (PCPs') immediate responses and follow-up care over approximately one year. In a selected subsample of at-risk patients, manual EHR chart review further assessed follow-up care and adherence to guidelines for the management of adolescent depression in primary care.

Results indicated that, across 27 practices conducting screening, 76.25% (n=6,981) of patients attending their age 16 well visit were screened. About one-quarter of screened patients had an elevated score (6.73% threshold; 19.23% subthreshold). On the date of their well visit, 37.28% of at-risk patients received active follow-up by their PCP (e.g., behavioral health referral, emergency procedures for suicidality) according to EHR-extracted progress note documentation. Over one year, 75.54% of patients with threshold scores and 39.97% of patients with subthreshold scores received follow-up care (e.g., depressive disorder diagnosis, antidepressant medication) according to EHR data extraction. More detailed examination via manual EHR chart review suggested higher follow-up rates.

This study demonstrated that, using current technologies, routine adolescent depression screening is feasible across diverse primary care settings. For many adolescents, screening identified previously undetected concerns and resulted in treatment initiation. However, PCPs require additional support to manage increased adolescent depression identification through universal screening programs. Investment in primary care-based care coordination and mental health services is needed to ensure high-quality treatment and ultimately decrease the burden of adolescent depression.
Subject (authority = RUETD)
Topic
Psychology
Subject (authority = LCSH)
Topic
Depression in adolescence
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_9087
PhysicalDescription
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application/pdf
InternetMediaType
text/xml
Extent
1 online resource (vii, 78 pages)
Note (type = degree)
M.S.
Note (type = bibliography)
Includes bibliographical references
RelatedItem (type = host)
TitleInfo
Title
School of Graduate Studies Electronic Theses and Dissertations
Identifier (type = local)
rucore10001600001
Location
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NjNbRU
Identifier (type = doi)
doi:10.7282/t3-w7g7-2j12
Genre (authority = ExL-Esploro)
ETD graduate
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
McCarthy
GivenName
Alyssa
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2018-06-29 11:32:16
AssociatedEntity
Name
Alyssa McCarthy
Role
Copyright holder
Affiliation
Rutgers University. School of Graduate Studies
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

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ETD
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windows xp
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DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2018-06-29T15:24:36
DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2018-06-29T15:24:36
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