What screening sequence is recommended for adolescent depression?

What screening sequence is recommended for adolescent depression?

• A. PHQ-2, followed by PHQ-A
• B. PHQ-9 only
• C. GAD-7
• D. PHQ-5

Answer: (A)

Screening adolescents for depression uses a two-step approach: start with a quick, initial screen and then follow up with a more detailed adolescent-specific assessment if the first screen is positive. The PHQ-2 asks two core symptoms—depressed mood and anhedonia—over the past two weeks. It’s designed to be very quick and sensitive, so it’s good at catching most those who may have depression without burdening patients with a longer questionnaire. If the PHQ-2 is positive, moving to the adolescent version of the PHQ-9 (PHQ-A) provides a fuller picture. The PHQ-A aligns with DSM-5 criteria, gives a sense of symptom severity and impairment, and includes a question about suicidality. This information is crucial for planning next steps, safety considerations, and treatment decisions. Other tools listed aren’t ideal for this two-step adolescent screen. The GAD-7 assesses anxiety, not depression, and isn’t the recommended follow-up after a positive depressive screen. The PHQ-5 is a shorter screening option but is not the established adolescent follow-up after a positive PHQ-2 in many guidelines. So the sequence of a brief PHQ-2 first, then the adolescent-specific PHQ-A second, best serves efficiency, accuracy, and safety in primary care.

Screening adolescents for depression uses a two-step approach: start with a quick, initial screen and then follow up with a more detailed adolescent-specific assessment if the first screen is positive.

The PHQ-2 asks two core symptoms—depressed mood and anhedonia—over the past two weeks. It’s designed to be very quick and sensitive, so it’s good at catching most those who may have depression without burdening patients with a longer questionnaire.

If the PHQ-2 is positive, moving to the adolescent version of the PHQ-9 (PHQ-A) provides a fuller picture. The PHQ-A aligns with DSM-5 criteria, gives a sense of symptom severity and impairment, and includes a question about suicidality. This information is crucial for planning next steps, safety considerations, and treatment decisions.

Other tools listed aren’t ideal for this two-step adolescent screen. The GAD-7 assesses anxiety, not depression, and isn’t the recommended follow-up after a positive depressive screen. The PHQ-5 is a shorter screening option but is not the established adolescent follow-up after a positive PHQ-2 in many guidelines. So the sequence of a brief PHQ-2 first, then the adolescent-specific PHQ-A second, best serves efficiency, accuracy, and safety in primary care.