Abstract

Objective: To determine if screening for major depressive disorder (MDD) increased in a national sample of privately insured adolescents following the US Preventive Services Task Force 2009 endorsement of universal screening for adolescent MDD. Study design: This was a retrospective cohort study of 12- to 14-year-old adolescents, continuously insured from 2010 to 2014 based on the MarketScan database. The primary outcome was the frequency of MDD screening, defined by International Classification of Diseases, Ninth Revision or Current Procedural Terminology code within the context of a well-visit. Multivariable analysis identified factors associated with MDD screening. Results: Adolescents (n = 413 080) were 49% female and 89% urban, and 21% had a family history of depression. Adolescents averaged 2.9 ± 1.6 well-visits during the 5-year study period. Of the cohort, 1.8% had MDD screening coded. Coding for MDD screening was more likely for urban residents (OR, 1.95; 95% CI, 1.69-2.25; P <.001), those with conduct disorder (OR, 1.37; 95% CI, 1.14-1.64; P <.001), and adolescents with more well visits (OR, 1.25; 95% CI, 1.21-1.31; P <.001). Coding for MDD screening was 96% less likely for those switching between multiple provider types for well-visits compared with pediatric providers. A family history of depression did not influence coding for MDD screening. Conclusions: MDD screening remains insufficient to address the youth mental health crisis. Furthermore, this study captures those adolescents most able to receive such services, given their continuous enrollment in private insurance. Disparities persist, with adolescents who are rural, less frequently seen, and with poor continuity of care less likely to receive screening.

Original languageEnglish (US)
Pages (from-to)203-207
Number of pages5
JournalJournal of Pediatrics
Volume204
DOIs
StatePublished - Jan 1 2019

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Major Depressive Disorder
Current Procedural Terminology
Depression
Conduct Disorder
Continuity of Patient Care
International Classification of Diseases
Advisory Committees
Insurance
Statistical Factor Analysis
Mental Health
Cohort Studies
Retrospective Studies
Databases
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{5917873486394b4d920fae3da81dc395,
title = "Major Depressive Disorder Screening Remains Low Even Among Privately Insured Adolescents",
abstract = "Objective: To determine if screening for major depressive disorder (MDD) increased in a national sample of privately insured adolescents following the US Preventive Services Task Force 2009 endorsement of universal screening for adolescent MDD. Study design: This was a retrospective cohort study of 12- to 14-year-old adolescents, continuously insured from 2010 to 2014 based on the MarketScan database. The primary outcome was the frequency of MDD screening, defined by International Classification of Diseases, Ninth Revision or Current Procedural Terminology code within the context of a well-visit. Multivariable analysis identified factors associated with MDD screening. Results: Adolescents (n = 413 080) were 49{\%} female and 89{\%} urban, and 21{\%} had a family history of depression. Adolescents averaged 2.9 ± 1.6 well-visits during the 5-year study period. Of the cohort, 1.8{\%} had MDD screening coded. Coding for MDD screening was more likely for urban residents (OR, 1.95; 95{\%} CI, 1.69-2.25; P <.001), those with conduct disorder (OR, 1.37; 95{\%} CI, 1.14-1.64; P <.001), and adolescents with more well visits (OR, 1.25; 95{\%} CI, 1.21-1.31; P <.001). Coding for MDD screening was 96{\%} less likely for those switching between multiple provider types for well-visits compared with pediatric providers. A family history of depression did not influence coding for MDD screening. Conclusions: MDD screening remains insufficient to address the youth mental health crisis. Furthermore, this study captures those adolescents most able to receive such services, given their continuous enrollment in private insurance. Disparities persist, with adolescents who are rural, less frequently seen, and with poor continuity of care less likely to receive screening.",
author = "Deepa Sekhar and Ba, {Djibril M.} and Guodong Liu and Jennifer Kraschnewski",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jpeds.2018.07.086",
language = "English (US)",
volume = "204",
pages = "203--207",
journal = "Journal of Pediatrics",
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Major Depressive Disorder Screening Remains Low Even Among Privately Insured Adolescents. / Sekhar, Deepa; Ba, Djibril M.; Liu, Guodong; Kraschnewski, Jennifer.

In: Journal of Pediatrics, Vol. 204, 01.01.2019, p. 203-207.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Major Depressive Disorder Screening Remains Low Even Among Privately Insured Adolescents

AU - Sekhar, Deepa

AU - Ba, Djibril M.

AU - Liu, Guodong

AU - Kraschnewski, Jennifer

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To determine if screening for major depressive disorder (MDD) increased in a national sample of privately insured adolescents following the US Preventive Services Task Force 2009 endorsement of universal screening for adolescent MDD. Study design: This was a retrospective cohort study of 12- to 14-year-old adolescents, continuously insured from 2010 to 2014 based on the MarketScan database. The primary outcome was the frequency of MDD screening, defined by International Classification of Diseases, Ninth Revision or Current Procedural Terminology code within the context of a well-visit. Multivariable analysis identified factors associated with MDD screening. Results: Adolescents (n = 413 080) were 49% female and 89% urban, and 21% had a family history of depression. Adolescents averaged 2.9 ± 1.6 well-visits during the 5-year study period. Of the cohort, 1.8% had MDD screening coded. Coding for MDD screening was more likely for urban residents (OR, 1.95; 95% CI, 1.69-2.25; P <.001), those with conduct disorder (OR, 1.37; 95% CI, 1.14-1.64; P <.001), and adolescents with more well visits (OR, 1.25; 95% CI, 1.21-1.31; P <.001). Coding for MDD screening was 96% less likely for those switching between multiple provider types for well-visits compared with pediatric providers. A family history of depression did not influence coding for MDD screening. Conclusions: MDD screening remains insufficient to address the youth mental health crisis. Furthermore, this study captures those adolescents most able to receive such services, given their continuous enrollment in private insurance. Disparities persist, with adolescents who are rural, less frequently seen, and with poor continuity of care less likely to receive screening.

AB - Objective: To determine if screening for major depressive disorder (MDD) increased in a national sample of privately insured adolescents following the US Preventive Services Task Force 2009 endorsement of universal screening for adolescent MDD. Study design: This was a retrospective cohort study of 12- to 14-year-old adolescents, continuously insured from 2010 to 2014 based on the MarketScan database. The primary outcome was the frequency of MDD screening, defined by International Classification of Diseases, Ninth Revision or Current Procedural Terminology code within the context of a well-visit. Multivariable analysis identified factors associated with MDD screening. Results: Adolescents (n = 413 080) were 49% female and 89% urban, and 21% had a family history of depression. Adolescents averaged 2.9 ± 1.6 well-visits during the 5-year study period. Of the cohort, 1.8% had MDD screening coded. Coding for MDD screening was more likely for urban residents (OR, 1.95; 95% CI, 1.69-2.25; P <.001), those with conduct disorder (OR, 1.37; 95% CI, 1.14-1.64; P <.001), and adolescents with more well visits (OR, 1.25; 95% CI, 1.21-1.31; P <.001). Coding for MDD screening was 96% less likely for those switching between multiple provider types for well-visits compared with pediatric providers. A family history of depression did not influence coding for MDD screening. Conclusions: MDD screening remains insufficient to address the youth mental health crisis. Furthermore, this study captures those adolescents most able to receive such services, given their continuous enrollment in private insurance. Disparities persist, with adolescents who are rural, less frequently seen, and with poor continuity of care less likely to receive screening.

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