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Pediatrics Questionnaires: The PHQ-9 Modified for Teens

The Patient Health Questionnaire-9, or PHQ-9 Modified for Teens linked here, is my favorite questionnaire to screen for depression. Questionnaires are especially valuable in for teen visits as a teenager may be less open about volunteering the details of his or her mood with open ended questions. A teenage patient's affect in the office may be totally different than the trends reported on the questionnaire. The PHQ-9 has only - you guessed it! - nine main questions with another four questions snuck in at the bottom. There are other questionnaires to screen for mood disorders, such as the Pediatric Symptom Checklist for Youth (PSC-Y), but PSC-Y has 35 questions and in my opinion is not necessary when giving the PHQ-9 accompanied by Vanderbilts if needed.

The top nine questions on the PHQ-9 ask about core symptoms of depression: depressed mood, anhedonia, fatigue, change in sleep, change in appetite/weight, guilt, loss of confidence, decreased concentration, and psychomotor agitation or retardation. These are scored on a "0" (not at all) to "3" (nearly every day) scale. The next two questions ask about impairment in daily activities as a result of the symptoms experienced. The last two questions ask about suicidality and suicide attempts.

Total scores 11 or greater are considered positive for depression. Scores less than 11 may be significant for mild depression or dysthymia. Any positive answer to the last two questions on suicidality/suicide attempts is considered positive and warrants further evaluation and referral for counseling.

I review PHQ-9 results with my teenage patients without family in the room, then discuss the results with the family within the bounds of confidentiality and after notifying the teen.

Have a wonderful day!

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