Depression and anxiety screening in adolescents with diabetes
Abstract
Adolescents with diabetes are at increased risk for depression and anxiety, which when untreated negatively affects diabetes control. During a 6-month period, the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) screening tool was utilized. Those with a positive screen then completed the Patient Health Questionnaire for Adolescents (PHQ-A) and the Generalized Anxiety Disorder 7-item (GAD-7) scale. In this article, we report on the correlations in outcomes between the PHQ-4 and the PHQ-A and GAD-7 and its clinical utility for determining the need for standard versus acute behavioral health care. Over 6 months, 77 patients aged 10 to 18 years screened positive on the PHQ-4. Thirty-two patients had positive screening with the PHQ-A and/or the GAD-7. Thoughts of self-harm were reported by 13 (40%), with 1 experiencing current/active symptoms. The PHQ-4 as a screening tool was able to identify adolescents with symptoms of depression and/or anxiety who would benefit from further evaluation by a behavioral health provider.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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 [339]
Cites
An Ultra-Brief Screening Scale for Anxiety and Depression: The PHQ–4
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2009) · Psychosomatics · doi:10.1016/s0033-3182(09)70864-3 · Cited by 4,261 · see citing works
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A., & Brähler, E. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.019 · Cited by 2,473 · see citing works
Childhood and Adolescent Psychiatric Disorders as Predictors of Young Adult Disorders
Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.85 · Cited by 844 · 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
Psychiatric disorders in youths with IDDM: rates and risk factors
Kovacs, M., Goldston, D., Obrosky, D. S., & Bonar, L. K. (1997) · Diabetes Care · doi:10.2337/diacare.20.1.36 · Cited by 394 · see citing works
Lawrence, J. M., Standiford, D. A., Loots, B., Klingensmith, G. J., Williams, D. E., Ruggiero, A., Liese, A. D., Bell, R. A., Waitzfelder, B. E., McKeown, R. E., et al. (2006) · Pediatrics · doi:10.1542/peds.2005-1398 · Cited by 329 · see citing works
Comorbidity of Anxiety and Depression in Children and Adolescents: An Integrative Review
Seligman, L. D., & Ollendick, T. H. (1998) · Clinical Child and Family Psychology Review · doi:10.1023/a:1021887712873 · Cited by 258 · see citing works
Herzer, M., & Hood, K. K. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp063 · Cited by 218 · see citing works
US Preventive Services Task Force (2009) · PEDIATRICS · doi:10.1542/peds.2008-2381 · Cited by 205 · see citing works
12. Children and Adolescents: Standards of Medical Care in Diabetes—2018
American Diabetes Association (2017) · Diabetes Care · doi:10.2337/dc18-s012 · Cited by 196 · see citing works
Northam, E. A., Matthews, L. K., Anderson, P. J., Cameron, F. J., & Werther, G. A. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01370.x · Cited by 195 · see citing works
Depressive Symptoms Predict Hospitalization for Adolescents With Type 1 Diabetes Mellitus
Stewart, S. M., Rao, U., Emslie, G. J., Klein, D., & White, P. C. (2005) · Pediatrics · doi:10.1542/peds.2004-1717 · Cited by 159 · 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
Psychological screening in adolescents with type 1 diabetes predicts outcomes one year later
Hilliard, M. E., Herzer, M., Dolan, L. M., & Hood, K. K. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.05.027 · Cited by 122 · see citing works
Foy, J. M. (2010) · PEDIATRICS · doi:10.1542/peds.2010-0788c · Cited by 121 · see citing works
Suicidal Ideation and Behavior and Noncompliance With the Medical Regimen Among Diabetic Adolescents
Goldston, D. B., Kelley, A. E., Reboussin, D. M., Daniel, S. S., SMITH, J. A., Schwartz, R. P., Lorentz, W., & HILL, C. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/s0890-8567(09)66561-8 · Cited by 118 · see citing works
Kovacs, M., & Lopez‐Duran, N. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02230.x · Cited by 111 · see citing works
Vindel, A. C., Muñoz‐Navarro, R., Medrano, L. A., Ruiz‐Rodríguez, P., González‐Blanch, C., Gómez-Castillo, M. D., Capafons, A., Chacón, F., & Santolaya, F. J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.01.030 · Cited by 89 · see citing works
Psychiatric disorders and health-related quality of life in children with type 1 diabetes mellitus
Butwicka, A., Fendler, W., Zalepa, A., Szadkowska, A., Zawodniak-Szalapska, M., Gmitrowicz, A., & Mlynarski, W. (2016) · Psychosomatics · doi:10.1016/j.psym.2015.11.001 · Cited by 70 · see citing works
Nandakumar, A. L., Voort, J. L. V., Nakonezny, P. A., Orth, S. S., Romanowicz, M., Sonmez, A. I., Ward, J. A., Rackley, S. J., Huxsahl, J. E., & Croarkin, P. E. (2018) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2018.0112 · Cited by 65 · see citing works
Mental health in adolescents with Type 1 diabetes: results from a large population-based study
Sivertsen, B., Petrie, K. J., Wilhelmsen‐Langeland, A., & Hysing, M. (2014) · BMC Endocrine Disorders · doi:10.1186/1472-6823-14-83 · Cited by 50 · see citing works
Anxiety in Children and Adolescents With Type 1 Diabetes
Majidi, S., Driscoll, K. A., & Raymond, J. K. (2015) · Current Diabetes Reports · doi:10.1007/s11892-015-0619-0 · Cited by 36 · see citing works
Agrawal, J., Kumar, R., Malhi, P., & Dayal, D. (2016) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2015-0335 · Cited by 22 · see citing works
Neuropsychological and Psychosocial Correlates of Endocrine and Metabolic Disorders - A Review
NORTHAM, E. A. (2004) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2004.17.1.5 · Cited by 13 · 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 (2022) · Diabetes Care · doi:10.2337/dc22-s005 · Cited by 445 · see citing works
Anand, P., Bhurji, N., Williams, N., & Desai, N. (2021) · Journal of Primary Care & Community Health · doi:10.1177/21501327211053750 · Cited by 49 · 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
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. (2021) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2021.01.011 · Cited by 17 · see citing works
- Authors
- Watson, S. E., Spurling, S. E., Fieldhouse, A. M., Montgomery, V. L., & Wintergerst, K. A.
- Affiliations
- University of Louisville (US)
- Corresponding author
- Watson, Sara E.
- Venue
- Clinical Pediatrics
- Publisher
- SAGE Publications
- Published
- 2020-02-17
- Volume
- 59
- Issue
- 4-5
- Pages
- 445-449
- ISSN
- 0009-9228 (ISSN-L)
- 1938-2707
- OpenAlex
- W3008971193
- Cited by
- 42
- References
- 25
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 9 · 2021: 6 · 2020: 2
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- adolescent diabetes, depression screening, anxiety screening, PHQ-4, PHQ-A, GAD-7, self-harm, behavioral health services, diabetes management, psychometric validation
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Depressive Disorder, Diabetes Mellitus, Type 1, Female, Humans, Mass Screening, Psychiatric Status Rating Scales
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
