ADA guidelines recommend regularly screening teens for depression. We examined sensitivity and specificity of the long and short-form of the Patient Health Questionnaire (PHQ) to identify depressive disorders in teens with T1D against a gold-standard diagnostic interview.
Teens (N=100; Mean age = 15.0 ± 1.7; 60% Male; 87% white; Mean HbA1c = 8.88 ± 1.8%) completed the PHQ-9 electronically. We used the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS DSM-5) depression module to determine whether the teen met criteria for any depressive disorder (DD; e.g., major depression, dysthymia, adjustment disorder-depressed mood, bipolar). We compared teens’ pre-existing PHQ cut-off scores (PHQ-9 ≥ 10; PHQ-2 ≥ 3) to KSADS results.
Per KSADS, 15% of teens met criteria for current DD, 11% endorsed past DD, and 25% endorsed past/present suicidal ideation (SI). Only 6% and 8% of teens exceeded PHQ-9 and PHQ-2 cut-off scores, respectively, and 10% endorsed current SI on PHQ item 9. Sensitivity and specificity outcomes are in Table 1.
The PHQ-9 and PHQ-2 showed low sensitivity and high false negative rates. Lower cut-offs or alternative screening measures may be indicated to reliably identify DD in teens with T1D. High rates of reported SI, even by teens who did not meet full criteria for DD, highlight the importance of screening for suicidality and/or treating subthreshold depressive symptoms.
A.M. Marker: None. R. McDonough: None. A. Egan: None. M.A. Clements: Advisory Panel; Self; Glooko, Inc. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Medtronic. S.R. Patton: None.