Multisite examination of depression screening scores and correlates among adolescents and young adults with type 2 diabetes
Open accessAbstract
Objectives Our aim was to evaluate self-reported depressive symptoms and clinical outcomes during routine screening for adolescents and young adults with type 2 diabetes (T2D), and examine associations among depressive symptoms and demographic and clinical characteristics.Methods The Patient Health Questionnaire (PHQ) was administered to 197 adolescents and young adults with T2D using the PHQ-2 or PHQ-9 in routine pediatric diabetes care at 4 academic medical centres. Data from electronic health records were extracted from the screening date and 12 months earlier.Results Adolescents and young adults with T2D (mean age, 16.85 years; 57% male; 77.2% non-Caucasian) completed the PHQ as part of routine diabetes care. On the PHQ, 19.3% of adolescents and young adults endorsed elevated depressive symptoms (PHQ score ≥10) and, among a subsample with item-level data (n=53), 18.9% endorsed thoughts of self-harm. Subsequently, 50.0% of those with depressive symptoms had a documented referral for mental health treatment in the electronic health record after the positive screening outcome. Older age, shorter diabetes duration, higher glycated hemoglobin level, being non-Hispanic white, more blood glucose checks per day and being prescribed oral medications were significantly associated with more depressive symptoms.Conclusions Screening for depressive symptoms identifies individuals in need of referral for mental health treatment. A focus on self-harm assessment, standardized methods for documentation of symptoms and mental health referrals and increased referral resources are needed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Multisite studies have demonstrated feasibility of implementing depressive symptom screening protocols in diabetes clinics.
“Multisite studies have demonstrated feasibility of implementing depressive symptom screening protocols in diabetes clinics and published practical guides for implementation (336)(337)(338)(339)391).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [338]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003) · Medical Care · doi:10.1097/01.mlr.0000093487.78664.3c · Cited by 6,359 · see citing works
Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., Imperatore, G., Linder, B., Marcovina, S., Pettitt, D. J., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1610187 · Cited by 1,476 · see citing works
Young-Hyman, D., de Groot, M., Hill-Briggs, F., Gonzalez, J. S., Hood, K., & Peyrot, M. (2016) · Diabetes Care · doi:10.2337/dc16-2053 · Cited by 1,072 · see citing works
Self-citationType 2 diabetes in adolescents and young adults
Lascar, N., Brown, J., Pattison, H., Barnett, A. H., Bailey, C. J., & Bellary, S. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30186-9 · Cited by 824 · see citing works
The patient health questionnaire for adolescents
Johnson, J. G., Harris, E. S., Spitzer, R. L., & Williams, J. B. W. (2002) · Journal of Adolescent Health · doi:10.1016/s1054-139x(01)00333-0 · Cited by 810 · see citing works
Richardson, L. P., McCauley, E., Grossman, D. C., McCarty, C. A., Richards, J., Russo, J. E., Rockhill, C., & Katon, W. (2010) · Pediatrics · doi:10.1542/peds.2010-0852 · Cited by 806 · see citing works
Buchberger, B., Huppertz, H., Krabbe, L., Lux, B., Mattivi, J. T., & Siafarikas, A. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.04.019 · Cited by 471 · see citing works
Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities
Nadeau, K. J., Anderson, B. J., Berg, E. G., Chiang, J. L., Chou, H., Copeland, K. C., Hannon, T. S., Huang, T. T.-K., Lynch, J. L., Powell, J., et al. (2016) · Diabetes Care · doi:10.2337/dc16-1066 · Cited by 381 · see citing works
Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016
Andes, L. J., Cheng, Y. J., Rolka, D. B., Gregg, E. W., & Imperatore, G. (2020) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2019.4498 · Cited by 380 · see citing works
Evaluation of the PHQ-2 as a Brief Screen for Detecting Major Depression Among Adolescents
Richardson, L. P., Rockhill, C., Russo, J. E., Grossman, D. C., Richards, J., McCarty, C., McCauley, E., & Katon, W. (2010) · Pediatrics · doi:10.1542/peds.2009-2712 · Cited by 377 · see citing works
Delamater, A. M., de Wit, M., McDarby, V., Malik, J. A., Hilliard, M. E., Northam, E., & Acerini, C. L. (2018) · Pediatric Diabetes · doi:10.1111/pedi.12736 · Cited by 279 · see citing works
Hood, K. K., Beavers, D. P., Yi‐Frazier, J. P., Bell, R. A., Dabelea, D., McKeown, R. E., & Lawrence, J. M. (2014) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2014.03.011 · Cited by 165 · see citing works
Responsiveness of the PHQ-9 to Psychopharmacological Depression Treatment
Löwe, B., Karapanagiotou‐Schenkel, I., Carney, C. P., & Göbel, C. (2005) · Psychosomatics · doi:10.1176/appi.psy.47.1.62 · Cited by 132 · see citing works
Improving Depression Screening for Adolescents With Type 1 Diabetes
Corathers, S. D., Kichler, J., Jones, N. Y., Houchen, A., Jolly, M., Morwessel, N., Crawford, P., Dolan, L. M., & Hood, K. K. (2013) · PEDIATRICS · doi:10.1542/peds.2013-0681 · Cited by 130 · see citing works
Silverstein, J. H., Cheng, P., Ruedy, K. J., Kollman, C., Beck, R. W., KLINGENSMITH, G. J., Wood, J., Willi, S. M., Bacha, F. F., Lee, J. M., et al. (2015) · Diabetes Care · doi:10.2337/dc15-0982 · Cited by 104 · see citing works
Depressive Symptoms and Quality of Life in Adolescents With Type 2 Diabetes
Anderson, B. J., Edelstein, S. L., Walders‐Abramson, N., Katz, L. E. L., Yasuda, P. M., Lavietes, S. J., Trief, P. M., Tollefsen, S. E., McKay, S. V., Kringas, P., et al. (2011) · Diabetes Care · doi:10.2337/dc11-0431 · Cited by 96 · see citing works
Metabolic and Inflammatory Links to Depression in Youth With Diabetes
Hood, K. K., Lawrence, J. M., Anderson, A., Bell, R. A., Dabelea, D., Daniels, S. R., Rodríguez, B. L., Dolan, L. M., & for the SEARCH for Diabetes in Youth Study Group (2012) · Diabetes Care · doi:10.2337/dc11-2329 · Cited by 92 · see citing works
Suicide Risk Assessment in Youth and Young Adults With Type 1 Diabetes
Majidi, S., O’Donnell, H. K., STANEK, K. R., Youngkin, E. M., Gomer, T., & Driscoll, K. A. (2019) · Diabetes Care · doi:10.2337/dc19-0831 · Cited by 60 · see citing works
Correlates of Depressive Symptoms in Urban Youth at Risk for Type 2 Diabetes Mellitus
Jaser, S. S., Holl, M. G., Jefferson, V., & Grey, M. J. (2009) · Journal of School Health · doi:10.1111/j.1746-1561.2009.00411.x · Cited by 47 · see citing works
Depression and anxiety screening in adolescents with diabetes
Watson, S. E., Spurling, S. E., Fieldhouse, A. M., Montgomery, V. L., & Wintergerst, K. A. (2020) · Clinical Pediatrics · doi:10.1177/0009922820905861 · Cited by 42 · see citing works
Matlock, K. A., Jones, N. Y., Corathers, S. D., & Kichler, J. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.05.004 · Cited by 40 · see citing works
McGill, D. E., Volkening, L. K., POBER, D. M., MUIR, A. B., Young-Hyman, D. L., & Laffel, L. M. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.09.017 · Cited by 33 · see citing works
Marker, A. M., Patton, S. R., McDonough, R., Feingold, H., Simon, L., & Clements, M. A. (2019) · Pediatric Diabetes · doi:10.1111/pedi.12886 · Cited by 32 · see citing works
Depression in Youth-Onset Type 2 Diabetes
Gulley, L. D., & Shomaker, L. B. (2020) · Current Diabetes Reports · doi:10.1007/s11892-020-01334-8 · Cited by 31 · see citing works
Mulvaney, S. A., Mara, C. A., Kichler, J. C., Majidi, S., Driscoll, K. A., Westen, S. C., Rawlinson, A., Jacobsen, L. M., Adams, R. N., Hood, K. K., et al. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz171 · Cited by 26 · see citing works
Depression in context: Important considerations for youth with type 1 vs type 2 diabetes
Wong, J. J., Addala, A., Abujaradeh, H., Adams, R. N., Barley, R. C., Hanes, S. J., Iturralde, E., Lanning, M. S., Naranjo, D. M., Tanenbaum, M. L., et al. (2019) · Pediatric Diabetes · doi:10.1111/pedi.12939 · Cited by 25 · see citing works
Identifying depressive symptoms among diabetes type and the impact on hemoglobin A 1c
Glick, B. A., Hong, K. M. C., Obrynba, K. S., Kamboj, M. K., & Hoffman, R. P. (2018) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2017-0241 · Cited by 20 · see citing works
Buren, D. J. V., Wilfley, D. E., Marcus, M. D., Anderson, B. J., Walders‐Abramson, N., Berkowitz, R. I., Ievers‐Landis, C. E., Trief, P. M., Yasuda, P. M., & Hirst, K. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.11.008 · Cited by 19 · see citing works
Vassilopoulos, A., Nicholl, M., Wolf, R. M., Slifer, K. J., & Cirincione, L. (2020) · Diabetes Spectrum · doi:10.2337/ds20-0010 · Cited by 18 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Eichorst, B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s005 · Cited by 305 · see citing works
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A. K., Ekhlaspour, L., Hassanein, M. M., Hilliard, M. E., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s005 · Cited by 325 · see citing works
14. Children and Adolescents: Standards of Care in Diabetes—2023
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D. M., Johnson, E. L., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s014 · Cited by 210 · see citing works
14. Children and Adolescents: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s014 · Cited by 173 · see citing works
14. Children and Adolescents: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., Lingvay, I., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s014 · Cited by 178 · see citing works
Bajaj, M. S., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Early, K. B., ChallaSivaKanaka, S., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc26-s005 · Cited by 178 · see citing works
ISPAD Clinical Practice Consensus Guidelines 2024: Type 2 Diabetes in Children and Adolescents
SHAH, A. S., Pérez, M. B., CHANG, N. T., Fu, J., Hannon, T. S., Kelsey, M. M., Peña, A. S., Pinhas‐Hamiel, O., Urakami, T., Wicklow, B. A., et al. (2024) · Hormone Research in Paediatrics · doi:10.1159/000543033 · Cited by 81 · see citing works
Corathers, S. D., Williford, D. N., Kichler, J., SMITH, L. B., OSPELT, E. L., Rompicherla, S., Roberts, A. J. C., Prahalad, P., Basina, M., Muñoz, C., et al. (2022) · Current Diabetes Reports · doi:10.1007/s11892-022-01497-6 · Cited by 22 · see citing works
Mental Health Comorbidity Is Common in Children With Type 2 Diabetes
Sellers, E. A. C., McLeod, L., Prior, H. J., Drăgan, R., Wicklow, B. A., & Ruth, C. (2021) · Pediatric Diabetes · doi:10.1111/pedi.13389 · Cited by 20 · see citing works
Hoffman, R. P., Damilano, C. P., Hong, K. M. C., Glick, B. A., & Kamboj, M. K. (2022) · Acta Diabetologica · doi:10.1007/s00592-022-01902-2 · Cited by 14 · see citing works
Young‐onset type 2 diabetes—Epidemiology, pathophysiology, and management
Luk, A. O. Y., Wu, H., Fan, Y., Fan, B., Chun Kwan, O., & Chan, J. C.-N. (2025) · Journal of Diabetes Investigation · doi:10.1111/jdi.70081 · Cited by 10 · see citing works
Mental Health Matters: Limited Support Remains a Barrier to Optimal Care for Youth With Diabetes
Nakhla, M. M., Shulman, R. M., & DiMeglio, L. A. (2021) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2021.05.003 · Cited by 8 · see citing works
Muyisa, R. M. (2024) · Endocrine and Metabolic Science · doi:10.1016/j.endmts.2024.100213 · Cited by 2 · see citing works
Suicide Risk Screening in a Diverse Cohort of Youth With Type 1 and Type 2 Diabetes
Fatima, S., Prichett, L. M., Campbell, N., Snyder, M. C. N., Bifano, M. K., & Wolf, R. M. (2025) · Pediatric Diabetes · doi:10.1155/pedi/6662248 · Cited by 2 · see citing works
Ray, K. K. (2023) · Asian Social Work and Policy Review · doi:10.1111/aswp.12286 · Cited by 1 · see citing works
Wang, X., You, S., Tang, S., Xie, Y., & Wu, D. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1782080
- Authors
- Monaghan, M., Mara, C. A., Kichler, J. C., Westen, S. C., Rawlinson, A., Jacobsen, L. M., Adams, R. N., Stone, J. Y., Hood, K. K., & Mulvaney, S. A.
- Affiliations
- Children's National (US)
- Cincinnati Children's Hospital Medical Center (US)
- University of Windsor (CA)
- University of Florida Health (US)
- Stanford Medicine (US)
- Vanderbilt University (US)
- Corresponding author
- Monaghan, Maureen
- ORCID
- Venue
- Canadian Journal of Diabetes
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 45
- Issue
- 5
- Pages
- 411-416
- ISSN
- 1499-2671 (ISSN-L)
- PMC
- PMC8238813
- OpenAlex
- W3123677441
- Cited by
- 17
- References
- 30
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 2
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Canadian Journal of Diabetes (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR001427, UL1TR002243)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- depression screening, type 2 diabetes, adolescents, young adults, depressive symptoms, Patient Health Questionnaire, self-harm, mental health referral, HbA1c, diabetes duration, blood glucose monitoring, oral antidiabetic drugs, pediatric diabetes care
- MeSH terms
- Patient Health Questionnaire, Adolescent, Depression, Diabetes Mellitus, Type 2, Female, Humans, Male, Mass Screening, Risk Factors, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
