Suicide risk in adolescents with chronic illness: implications for primary care and specialty pediatric practice: a review.
Dev Med Child Neurol. 2010 Aug 31;
Authors: Greydanus D, Patel D, Pratt H
Suicide in adolescents is a global tragedy. Research-identified correlates of suicide in youth include depression, academic failure, loss of friends, social isolation, and substance abuse, among others. This review focuses on the potential link between chronic illness in adolescents and increased suicide risk. Research suggests that chronic illness is a risk factor for depression in adolescents that may induce suicide ideation and attempts; however, this risk may be increased even more in young adulthood if the underlying causes of depression are not resolved. This risk needs to be considered against the research data noting an increase in suicide attempts and completions, in each decade of life from adolescence into adulthood. Although more research is clearly needed, it can be concluded that suicide risks are seen in adolescents with chronic illness and all of these young people should be screened for depression and other risk factors for suicide on a regular basis.
20813018
– Suicide risk in adolescents with chronic illness: implications for primary care and specialty pediatric practice: a review.
A study of the diagnostic accuracy of the PHQ-9 in primary care elderly.
BMC Fam Pract. 2010 Sep 1;11(1):63
Authors: Phelan E, Williams B, Meeker K, Bonn K, Frederick J, Logerfo J, Snowden M
ABSTRACT: BACKGROUND: The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care. METHODS: A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression. RESULTS: Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; P=0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; P=0.187). CONCLUSIONS: Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.
20807445
– A study of the diagnostic accuracy of the PHQ-9 in primary care elderly.
Primary care clinicians’ knowledge and confidence about newborn screening for sickle cell disease: randomized assessment of educational strategies.
J Natl Med Assoc. 2010 Aug;102(8):676-82
Authors: Oyeku SO, Feldman HA, Ryan K, Muret-Wagstaff S, Neufeld EJ
OBJECTIVE: In Massachusetts, primary care clinicians receive and act upon hemoglobinopathy newborn screening results. We assessed clinicians’ knowledge, confidence, and practices regarding hemoglobinopathy newborn screening, and the effect of mailed educational materials vs interactive seminar on knowledge and confidence. METHODS: A randomized educational intervention trial was performed at 15 community health sites. Practices were randomized to determine the order in which the educational interventions were administered: mailed educational materials first or interactive seminars on the management of hemoglobinopathy newborn screening results first. Clinicians’ demographics, knowledge, confidence, and practices were assessed by a survey. Posttests were administered soon after the intervention. RESULTS: Responses came from 85 of 170 eligible providers (50%). Twenty-nine percent of respondents provided both pretests and posttests. In respondents with paired data, knowledge on a 5-point scale improved by 1.4 +/- 0.4 (mean +/- standard error of the mean, p = .003), while self-efficacy on a 16-point scale increased by 1.3 +/- 0.3, p = .002. There were no significant differences between seminar and mailed-materials groups. CONCLUSIONS: Both educational strategies led to modest improvements in knowledge about newborn screening for hemoglobin disorders. Enhancing knowledge and confidence about newborn screening-related tasks may improve clinicians’ capacity to act upon newborn screening results for hemoglobinopathies.
20806678
– Primary care clinicians’ knowledge and confidence about newborn screening for sickle cell disease: randomized assessment of…
