Only one-third of adolescents are screened for emotional health during routine physicals
Most mental health problems begin in adolescence, with half of all lifetime mental health disorders starting by age 14. Yet only about one-third of adolescents reported discussing their emotional health during well-care visits with their primary care providers, according to a new study. This rate of screening for emotional distress is lower than screening rates for smoking, substance abuse, and sexual activity, note Elizabeth M. Ozer, Ph.D., of the University of California, San Francisco, and colleagues.
They assessed providers' rates of screening for emotional distress among a clinic-based sample and a population-based sample of adolescents aged 13 to 17. The clinic-based sample included 1,089 adolescents who had well visits to pediatric clinics of a managed care plan. The population-based sample included 899 adolescents who participated in the California Health Interview Survey (CHIS). Screening for emotional distress was based on adolescent self-report.
In both groups, significantly higher screening rates were reported by females. For example, in the population-based CHIS sample, female adolescents (37 percent) were more likely than males (26 percent) to report talking with their doctor about their emotional mood, and 36 percent of females were screened compared with 30 percent of males in the clinic sample. In the pediatric clinic group, older teens (aged 15-17) and Latinos were more likely to be screened. This pattern is consistent with growing rates of depression among Latinos.
Overall, nearly 70 percent of teens who reported depressive symptoms on the population-based survey had not had a recent discussion about their mood with their provider. Recent guidelines for general adolescent care advise providers to query about emotional functioning and depression. Yet the opportunities for such screening are not being well utilized, suggest the authors. They encourage primary care providers to use the primary care visit to screen adolescents for emotional health. This study was funded in part by the Agency for Healthcare Research and Quality (HS11095).
See "Are adolescents being screened for emotional distress in primary care?" by Dr. Ozer, Elaine G. Zahnd, Ph.D., Sally H. Adams, Ph.D., and others in the Journal of Adolescent Health 44, pp. 520-527, 2009.
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