Depression Screening Scores Research Articles

Association of inpatient postpartum recovery with patient-reported outcome measures following hospital discharge: a prospective cohort study

BackgroundThe relationship between the quality of inpatient versus outpatient obstetric postpartum recovery is under-explored. We examined the association between inpatient reported quality of recovery with outpatient global recovery, pain severity, pain interference, anxiety, and depression screening scores postpartum.MethodsWe conducted a multicenter observational cohort study of women in labor who underwent vaginal, operative vaginal, or intrapartum cesarean birth. Subjects completed baseline assessments of pain, social support, anxiety, and depression in early labor. We assessed the Obstetric Quality of Recovery-10 (ObsQoR-10) on the day of discharge and the ObsQoR-10, Global Health Scale (GHVAS; 0–100), Brief Pain Inventory (BPI), and the Edinburgh Postnatal Depression Scale (EPDS) on postpartum day seven. We hypothesized that the ObsQoR-10 scores at discharge would be useful in predicting postpartum day seven measures of recovery and postpartum depression screening scores.ResultsWe consented 558 subjects, 551/558(98%) completed baseline assessments, 400/551(72%) completed the ObsQoR-10 tool, and 344/551(62%) completed an EPDS assessment. Median (1st, 3rd quartile) ObsQoR-10 scores were 78 (63, 90) at discharge and 85 (68,93) on postpartum day seven, (difference of 7 [99% CI 2 to 13], P < 0.001). GHVAS on postpartum day seven identified 204/344 (59%) of subjects with good recovery. An ObsQoR-10 score of > 86 at discharge had a RR of 1.5 [95% CI 1.2 to 1.8], P < 0.001 for good recovery at postpartum day seven, the EPDS identified 20/344 (5.8%) respondents with a score ≥ 13 on postpartum day seven. The area under the curve between the ObsQoR-10 at discharge with an EPDS ≥ 13 was 0.74 (99% CI 0.61 to 0.86, P < 0.001). The RR for an EPDS ≥ 13 on postpartum day seven with an ObsQoR-10 < 77 on the day of discharge was 7.8 (95% CI 1.8 to 33.8; P = 0.001).ConclusionsObsQoR-10 scores at discharge and postpartum day seven demonstrated increased obstetric recovery in the post-discharge period. The observed association between the ObsQoR-10 and the EPDS, suggests that the ObsQoR-10 might facilitate identification of women at increased risk of postpartum anxiety or depression. Identification of high-risk women at discharge may allow early interventions to reduce morbidity secondary to postpartum depression.

Measuring Disparities in the Impact of COVID-19 on Pediatric Mental Health in Primary Care Settings.

To examine disparities in mental health diagnosis, depression screening, and depressive symptoms in pediatric primary care settings before and during the COVID-19 pandemic, and to evaluate the use of electronic health records to study temporal trends in pediatric mental and behavioral health (MBH). This is an IRB-approved, retrospective study of pediatric patients (n=10,866) who visited three primary care sites at an academic medical center before (2017-2019) and during (2020-2022) the COVID-19 pandemic. We used logistic regression to compare rates of diagnoses, depression screening, and depression symptom scores among demographic groups. This study demonstrates an increase in both PHQ-9A screening rates and average scores from 2017-2019 to 2020-2022. There were significant disparities in common mental health diagnoses, including higher rates of psychological distress among lower income and Hispanic patients, both before and during the pandemic, despite lower rates of screening among Hispanic patients. This suggests a need for improved equity in routine MBH screening and additional research to better understand the underlying social determinants that may be driving the greater mental health burden for certain marginalized youth.This study also highlights the strengths and challenges of utilizing EHR data to characterize disparities in pediatric mental illness. Although the nature of care delivery in an academic medical center clinic and the limitations of the EHR for collecting relevant data present challenges to this measurement, the EHR is nevertheless a promising tool for measuring and tracking pediatric mental health disparities.

Mental Health and Mobile Communication Profiles of Crowdsourced Participants.

Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) are highly prevalent and burdensome. To increase mental health screening rates, the digital health research community has been exploring the ability to augment self reporting instruments with digital logs. Crowdsourced workers are being increasingly recruited for behavioral health research studies as demographically representative samples are desired for later translational applications. Overshadowed by predictive modeling, descriptive modeling has the ability to expand knowledge and understanding of the clinical generalizability of models trained on data from crowdsourced participants. In this study, we identify mobile communication profiles of a crowdsourced sample. To achieve this, we cluster features derived from time series of call and text logs. The psychiatric, behavioral, and demographic characteristics were notably different across the four identified mobile communication profiles. For example, the profile that had the lowest average depression and anxiety screening scores only shared incoming text logs. This cluster had statistically significantly different depression and anxiety screening scores in comparison to the cluster that shared the most outgoing text logs. These profiles expose important insights regarding the generalizability of crowdsourced samples to more general clinical populations and increase understanding regarding the limitations of crowdsourced samples for translational mental health research.

The effect of the US Child Tax Credit advance payments in 2021 on adolescent mental health: Changes in depression symptoms and suicidality

ObjectiveChild poverty is associated with poor adolescent mental health. Changes to the Child Tax Credit (CTC) in 2021 in the U.S. were historic and introduced a new model of distributing the credit in advance of tax filing, providing families with stable, supplemental monthly income. This policy shift offers a unique opportunity to examine the mental health effects for adolescents. MethodsWe use electronic health record data from a large pediatric primary care network in Columbus, Ohio, which collected adolescent depression screening scores in real time as the CTC advance payments were introduced. We utilized differences in age of eligibility for the CTC to examine the changes in the probability of depression screening outcomes (positive depression screen, any depression symptom, any suicidal ideation), for adolescents eligible for the credit (turned 18 first quarter of 2022), relative to those not eligible (turned 18 last quarter of 2021) (n = 1,423). ResultsWe did not observe a significant association between the policy change and study outcomes in the overall sample. However, the percentage of adolescents with a positive depression screen significantly declined for Non-Hispanic Black (13.4 percentage point reduction, p = 0.01) and publicly insured (9.7 percentage point reduction, p = 0.04) adolescents. ConclusionsOur findings suggest reductions in depression symptoms for subgroups of adolescents who were age-eligible for the CTC compared to their counterparts who were not eligible. The CTC advance payments were a brief experiment in universal basic income and may offer a policy solution for addressing both poverty and a growing adolescent mental health crisis.

#2121 The Kidney-specific Psychosocial ASSessment and support (Kidney PASSPORT) feasibility trial

Abstract Background and Aims Psychosocial interventions for depressive and anxiety symptoms are effective in CKD, but studies mainly focus on people on dialysis. Little is known about the role of screening and prevention of common mental health difficulties in early CKD. This trial assessed the research feasibility of an intervention to screen for psychological distress in CKD and deliver prevention approaches for sub-threshold symptoms. The intervention was facilitated by an Assistant Wellbeing Practitioner (AWP), a Band 3 healthcare assistant familiar with renal services and upskilled with specific competency-based training. Method We conducted a mixed-methods, one-year, single-centre, prospective, single-blind, wait-list, randomised controlled feasibility trial. We anticipated screening 250 individuals to identify 100 eligible, with a 40% screening positivity rate, a 45% participation rate and 20% attrition rate, to give 36 participants in the feasibility study. Primary outcomes are shown in Table 1. Potential participants were screened using an online self-completion questionnaire. Participants were randomised to 6 months of immediate or wait-list intervention. Data was collected using online self-report surveys, clinical research forms and semi-structured qualitative interviews. The trial was overseen by a steering committee and received the relevant ethics approvals. Funders included Kidney Care UK, the British Renal Society, the Royal Devon and Exeter Research Capacity Awards and the Exeter Kidney Unit development fund. Results We approached n = 233 people. Feasibility outcomes are shown in Table 2. Due to logistical issues an extension was obtained and in total n = 24 participants were recruited, agreed by the steering committee. All clinical research forms were completed. The most common intervention components were self-management and liaison with the clinical team. The median (interquartile range) difference in baseline and post intervention PHQ-9 score was −5 (−7, 0), n = 19, p = 0.003) and GAD-7 score was −7 (−8, −2), n = 19, p = 0.0002). Qualitative findings showed the AWP was seen as filling in the gaps left by other parts of the service. Key themes were accessibility, time availability, empathy, patient empowerment, and ability to empower the individual. Balance—especially family, work and health—was noted to be a challenge for participants. Importantly, the AWP was able to help participants overcome previous negative experiences. The trial provided valuable learning regarding role implementation, including recruitment, training, work patterns, everyday practicalities, and supervision arrangements. Conclusion We propose a novel intervention for screening and addressing early mental health problems in people with CKD. A single-centre feasibility design was appropriate. The screening positivity rate was lower than anticipated, informing samples for future trials. Outcome data collection via self-report surveys was not feasible. The intervention was well received, with the AWP being valued and self-help and clinical liaison being core elements. Significant reductions in depression and anxiety screening scores were observed. Despite the rigorous design, limitations included slow initial recruitment impacting the sample size and AWP role vulnerability. Future work includes adapting the AWP training and role based on trial learning and considering suitability for other long-term conditions. In conclusion, the AWP role shows promise in routine screening for and prevention of common mental health difficulties in CKD.

Factors Associated With Persistent Bothersome Urinary Symptoms and Leakage After Pregnancy.

Urinary incontinence is a common postpartum morbidity that negatively affects quality of life. This study aimed to identify factors associated with persistent (ie, 12 months postpartum) bothersome urinary symptoms, including stress urinary incontinence (SUI) and urgency urinary incontinence (UUI), and explore their association with mental health in medically underserved communities. This was a cross-sectional analysis of a prospective study of individuals enrolled into "extending Maternal Care After Pregnancy," a program providing 12 months of postpartum care to individuals with health disparities. Patients were screened at 12 months for urinary dysfunction, anxiety, and depression using the Urinary Distress Index-6, Generalized Anxiety Disorder-7, and Edinburgh Postnatal Depression Scale, respectively. Bivariate and multivariable logistic regression analyses were performed for at-least-somewhat-bothersome SUI versus no-SUI, UUI versus no-UUI, and for bothersome versus asymptomatic urinary symptoms, using demographic and peripartum and postpartum variables as associated factors. Four hundred nineteen patients provided data at median 12 months postpartum. Patients were 77% Hispanic White and 22% non-Hispanic Black. After multivariable analysis, SUI (n = 136, 32.5%) was significantly associated with increasing body mass index at the time of delivery and greater depression screening scores. Fetal birthweight, mode of delivery, degree of laceration, and breastfeeding status were not associated. Urgency urinary incontinence (n = 69, 16.5%) was significantly associated with increasing parity and higher anxiety screening scores. Similarly, participants with urinary symptom bother had significantly greater parity and higher anxiety screening scores. At 12 months postpartum, bothersome urinary symptoms and incontinence were quite common. Since these are treatable, postpartum screening for urinary complaints-and associated anxiety and depression-is essential, as is assisting patients in achieving a healthy weight.

Distance to Burn Center Does Not Impact Long-term Anxiety and Depression Risk Following Burn Injury.

Burn injury predisposes patients to significant psychological morbidity, including anxiety, depression, and posttraumatic stress. Adding to the burden of injury, patients often require transfer to specialized burn centers located far from home. We hypothesized that greater distances between a patient's home address and the treating burn center would increase the rate of postinjury anxiety and depression. From January 2021 to June 2023, patients who were admitted to our American Burn Association verified center and seen for posthospitalization follow-up were identified. Demographics, burn characteristics, and follow-up anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-2) screening scores were reviewed. Comparisons between patients with positive and negative screens were performed using univariate analysis followed by logistic regression. Linear regression was used to evaluate the relationship between distance to the burn center and incremental screening scores. Of the 272 patients identified, 35.6% and 27.9% screened positive for anxiety and depression, respectively. The distance to burn center was not greater among patients with positive screens. Likewise, no statistically significant linear relationship was found between distance to the burn center and incremental screening scores. Morphine milligram equivalents on the last day of hospitalization (P = .04) and a prior psychiatric history (P < .001) all predicted postinjury anxiety. Total body surface area burned (P = .02) and a prior psychiatric history (P = .02) predicted postinjury depression. The distance between a patient's home and the treating burn center does not alter anxiety and depression rates following burn injury, further supporting the transfer of patients to specialized centers.

Dietary intake with supplementation of vitamin D, vitamin B6, and magnesium on depressive symptoms: a public health perspective.

This study aims to understand the impact of dietary intake through supplementation of vitamins D, B6, and magnesium on elevated depressive symptoms, a mental health illness that is a leading contributor to global disability and a public health concern. Multiple datasets from the National Health and Nutrition Examination Survey 2017-March 2020 investigated the associations between vitamin D, B6, and magnesium on depression screening scores. A cross-sectional sample of adults over 20 was extracted (n = 9,232). Chi-square tests and logistic regression analyses were used to investigate the associations. Individuals with low amounts of vitamin D (p = 0.0481) were more likely to report elevated depressive symptoms relative to those with low amounts of vitamin B6 (p = 0.0225). These results remained significant among those with high magnesium (p = 0.0133) proportionate to high vitamin B6 (p = 0.0225). In the age-adjusted model, a lower intake of vitamin D, vitamin B6, and magnesium showed a relationship with elevated depressive symptoms (Vitamin D: OR = 0.611, 95% CI 0.382-0.980 Vitamin B6: OR = 0.503, 95% CI 0.291-0.867 Magnesium: OR = 0.458, 95% CI 0.277-0.759). The fully adjusted regression model (gender, race/ethnicity, and household food security) showed that a lower intake of vitamin B6 and magnesium correlated with elevated depressive symptoms (Vitamin B6: OR = 0.439, 95% CI 0.260-0.738 Magnesium: OR = 0.465, 95% CI 0.303-0.714). Preventive measures could be addressed by identifying the risks of vitamin deficiencies. Further epidemiological research is needed for the individual effects of vitamin supplementation and depression screening scores. Future prospective cohort studies exploring these associations, focusing on daily dietary intake, are needed to validate the direction of causation further and understand the underlying mechanisms.

Differences in the human gut microbiota with varying depressive symptom severity scores.

Depression is a prevalent mental health disorder, and its incidence has increased further because of the coronavirus disease 2019 (COVID-19) pandemic. The gut microbiome has been suggested as a potential target for mental health treatment because of the bidirectional communication system between the brain and gastrointestinal tract, known as the gut-brain axis. We aimed to investigate the relationship between the human gut microbiome and depression screening by analyzing the abundance and types of microbiomes among individuals living in Japan, where mental health awareness and support may differ from those in other countries owing to cultural factors. We used a data-driven approach to evaluate the gut microbiome of participants who underwent commercial gut microbiota testing services and completed a questionnaire survey that included a test for scoring depressive tendencies. Our data analysis results indicated that no significant differences in gut microbiome composition were found among the groups based on their depression screening scores. However, the results also indicated the potential existence of a few differentially abundant bacterial taxa. Specifically, the detected bacterial changes in abundance suggest that the Bifidobacteriaceae, Streptococcaceae, and Veillonellaceae families are candidates for differentially abundant bacteria. Our findings should contribute to the growing body of research on the relationship between gut microbiome and mental health, highlighting the potential of microbiome-based interventions for depression treatment. The limitations of this study include the lack of clear medical information on the participants' diagnoses. Future research could benefit from a larger sample size and more detailed clinical information.

FEASIBILITY AND ACCEPTABILITY OF INSPIRATORY MUSCLE STRENGTH TRAINING AMONG OLDER ADULTS IN MYSORE, INDIA

Abstract Hypertension, a major risk for cardiovascular and cerebrovascular diseases, affects 1.3 billion globally and 229 million in India. While exercise has shown to lower blood pressure, 40% of older Indians report inadequate physical activity. Inspiratory Muscle Strength Training (IMST), a novel breathing exercise, shows promise for controlling hypertension, but little is known about its acceptability among older Indian adults. This study examined feasibility and acceptability of IMST in older adults with hypertension in Mysore, India. Between November-2022 and January-2023, 31 non-smoking adults aged 65 - 80 years, with a blood pressure □140/90 mm Hg were enrolled in a 6-week interventional study after informed-consent. Participants used a Power-breathe Plus breath trainer for 30 breaths a day, 5 days a week, for 6-weeks, weekly increasing resistance to a maximum of 30% of their Maximum Inspiratory Pressure. Participants underwent medical assessment, interviewer-administered survey to collect data on demographics, depression, cognition, physical performance, pulmonary function and acceptability, at baseline and post-intervention. Univariate analysis was conducted. Of 31 participants, 20% were male and 55% were on antihypertensive. Four participants discontinued by week two. Post-intervention, 22% had □10 mm Hg decrease in systolic- pressure and 37% □10 mm Hg decrease in diastolic- pressure. About 59% showed improvement in depression screening scores, 40% had improved cognitive scores and 48% reported improved physical-performance scores; 80% reported IMST was useful and 90% reported device was user-friendly; 45% reported improvements in breathlessness and exercise-tolerance. IMST was acceptable, feasible and safe as a hypertension intervention for older adults in Mysore, India.

Differences in mental health status between individuals living with diabetes, and pre-diabetes in Qatar: A cross-sectional study

AimsThe aims of this study was to determine the prevalence and to compare depression and anxiety screening scores by type of diabetes: type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), and pre-diabetes. The secondary aim was to examine sex differences in screening scores by type of diabetes. MethodsThis cross-sectional study was conducted in Doha, Qatar using primary data collection (N = 150), and stratified random sampling at a diabetes primary healthcare center. The study tool collected demographic information and used validated mental health screening tools for depressive symptoms “Patient Health Questionnaire-9 (PHQ-9)", and for anxiety symptoms “Generalized Anxiety Disorder 7 (GAD-7)". ResultsThe prevalence of moderate to severe depressive and anxiety scores was highest in the prediabetes group (20 % and 14 % respectively). There were increased PHQ-9 scores in the pre-diabetes group compared to T2DM (p-value <0.05). No statistically significant differences in depressive symptom scores were found when comparing the pre-diabetes group with T1DM, and T1DM with T2DM. When looking at sex differences, there were no statistically significant differences between T1DM and pre-diabetes males and females, however PHQ-9 and GAD-7 scores in T2DM females were poorer compared to T2DM males. ConclusionThe results of our study found patients living with pre-diabetes, and females with T2DM are vulnerable populations who should be screened for mental health disorders. Early screening for mental health disorders for individuals diagnosed with prediabetes, T1DM, and T2DM should be routinely conducted to potentially improve health outcomes.

Robot‐Administered Serious Brain Games for Older Adults with Mild Cognitive Impairment or early‐stage Alzheimer’s Disease: A Pilot Study

AbstractBackgroundTraditional methods for disease management have shown limited success treating AD/ADRD or mitigating its symptoms. Innovative technology such as Artificial Intelligence and Socially Robots, have begun to alleviate the growing need for novel solutions for AD/ADRD. While Socially Assistive Robots (SAR) are used to interact with patients with dementia or other mental disorders, to our knowledge, no such cooperative social robots have been studied to co‐play serious brain games with older adults with MCI or early‐stage AD/ADRD.MethodThe study involved 20 older adults (average age: 77.7; std: 6.43; 15 female) living in a care facility who were diagnosed with MCI or Early‐Stage ADRD (SLUMS 10‐25). They participated in 12 different games (e.g., Words, Picture Puzzle, Ryan Runs, Flow Control, Birds, Checkers, Solitaire, Birds Count, etc.) with a social companion robot named Ryan, every day for 8‐10 weeks. These games aimed to improve memory, cognitive function, and physical activity. Each participant had a Ryan device in their apartment and were trained on how to use it. The study collected data on usage time, win/loss rate, difficulty level, average score, and average duration per game, as well as depression screening (PHQ‐9) and SLUMS scores before, during, and after the study.ResultParticipants in the study spent 887 hours using Ryan. They spent 254 hours (28.7%) playing games on Ryan. On average they spent 12 minutes (std = 5 minutes) per day playing serious games with Ryan. Checkers, Flow Game, Picture Puzzle, Solitaire, and Word Puzzle, were the most popular games among all. On average, the SLUMS and PHQ‐9 scores improved by 3.3 and 2.43 points, respectively.ConclusionOur study also shows that on average, participants performed better over time in playing the games. For example, the average Win Rate or Scores of the participants in playing the Flow Game, Word Puzzle, improved over the weeks by about 0.5% and 29 scores, every week, respectively. That means participants were more engaged in playing those games and were able to focus and increase their score or win rate over time.

Assessment of Incidence of Distress and Utilization of Supportive Care Services in Multiple Myeloma Patients, a Retrospective Single Center Experience

Introduction: Multiple myeloma (MM) is the second most common hematological malignancy. Current literature represents substantial underutilization of guideline-recommended supportive services (SS) in MM patients. Earlier studies have shown that most patients with MM have focal osseous lesions leading to skeletal-related events, fractures, pain, and debility. These events may negatively affect the treatment course and result in poor quality of life. Recent NCCN and ASCO guidelines recommend utilization of SS in all patients by early integration of cancer care for symptom control while being treated for primary malignancy. We evaluated the level of distress in patients (pts), SS utilization, ED visits, and hospitalization in pts with MM. Methods: We included adult patients (≥18 years) with newly diagnosed or relapsed/refractory MM at Levine Cancer Institute who had completed an electronic distress survey (EDS) within three months of diagnosis or relapse. Amyloidosis and plasma cell leukemia diagnoses were excluded. The EDS includes questions related to sociodemographic, patient-reported outcomes (PROs): distress level, physical symptoms (scale 0 - 10), screening for depression (PHQ-2, scale 0 - 6), anxiety (GAD-2, scale 0 - 6),Utilization of at least one SS (social work, palliative medicine, psych-oncology, cancer rehab, integrative medicine, and nutrition) within 6 months of EDS and emergency department visits/hospitalizations within 1 year of EDS were collected, retrospectively, from the electronic medical record. The PROs were summarized overall and compared among three distress groups [Distress score (DS) &amp;lt;4, 4-6, ≥7] with Wilcoxon rank sum tests for the EDS symptom scores and Fisher's exact tests for other categorical endpoints. Results: 541 MM pts were identified with an EDS within 3 months of diagnosis or relapse (assessment date range: January 2017 - May 2022), with 71.5% of those occurring near diagnosis, and 28.5% occurring around relapse. The mean age was 64.9 years, 58.6% were male, and additional patient characteristics are presented in Table 1. There were 33.8% (n=183) pts with DS&amp;lt;4, 30.9% (167) with DS 4-6, and 35.3% (191) with DS of ≥7. The highest scoring EDS symptoms were pain (mean score 4.7), fatigue (5.1) and sleep disturbance (3.6). Broadly, patients with higher distress scores had higher symptom scores (p&amp;lt;0.05 for all symptoms). There were 77.6% (420) pts with anxiety GAD-2 score of 0-2, 12.9% (70) pts with a score of 3-4 and 9.4% (51) pts with a score of 5-6. Similarly, for depression, 76.9% (416) pts reported a PHQ-2 score of 0-2, 15% (81) with a score of 3-4, and 8.1% (44) with a score of 5-6. For anxiety and depression, patients with higher DS had higher depression and anxiety screening scores (p &amp;lt;0.001), as shown in Table 2. 64.3% (348) pts utilized at least one SS within six months of their initial EDS assessment. The rate of utilization of at least one SS increased with DS (49.2% in DS &amp;lt;4, 67.1% in DS 4-6, and 76.7% in DS ≥7; p value&amp;lt;0.001). Numerically, more patients with high distress had at least one ED visit within a year of EDS (25.7% DS &amp;lt;4, 33.5% DS 4-6, 36.1% DS ≥7, p = 0.08). There was no significant difference in hospitalization within 1 year between the DS groups. There were 147 (36.8%) pts with high-risk cytogenetics, of which 43.5% had a distress score of ≥7. The rate of utilization of SS, ED visits, and hospitalizations was numerically higher in pts with newly diagnosed MM (68.5%, 34.4%, 63.1%, respectively), as compared to pts with RRMM (64.3%, 25.3%, 48.7%). Conclusion: The disease-specific symptoms predict clinically significant DS &amp;gt;4 on EDS. There were about 20% of pts with screening score &amp;gt;2 for anxiety (GAD-2) &amp; depression (PHQ-2) that may warrant further exploration regarding the detail and nature of symptoms related to the diagnosis. There was a higher rate of utilization of SS and ED visits in pts with higher DS. Given these findings, there is a need to identify the optimal healthcare pathways for better utilization &amp; incorporation of these EDS and PROs in the clinical care of distressed patients. Our study indicates that more work is needed to align needs with resources in order to optimize quality of life and disease outcomes for our pts.

Within-individual variation of measured depression symptoms: A systematic review and meta-analysis

BackgroundDepression screening instruments are commonly used to assess the presence and severity of depression symptoms. However, there is little information on variation in depression screening scores over time within the same individual. MethodsA systematic review and meta-analysis was performed of studies reporting the within-subject variability of the Beck's Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-2 (PHQ-2). Multiple databases were searched from inception to 14th July 2023. Title and abstract screening was performed in duplicate, full text screening and data extraction by one reviewer and verified by a second. Risk of bias was assessed with a modified COSMIN tool. ResultsOf 2798 titles and abstracts and 157 full text articles screened, 41 met the inclusion criteria. No studies were on patients with depression, most had only two measurements, less than two weeks apart. The pooled estimates of ICCs (Intraclass Correlations) and 95 % confidence intervals for BDI, HADS, PHQ-9 and PHQ-2 were 0.89 (0.84–0.93), 0.89 (0.85–0.93), 0.84 (0.81–0.88) and 0.75 (0.56–0.93), respectively.Studies in healthy subgroups showed lower ICC than those with physical illness. LimitationsAssessment of variability is not the main aim of most papers assessing depression measurement instruments, so it is possible that some relevant papers have been missed. ConclusionsWithin-subject scores for BDI, HADS and PHQ-9, show generally excellent agreement over periods of up to two weeks. However published data on within-subject variability is lacking over longer time periods and for patients with depression.

477 Assessing the impact of elexacaftor-tezacaftor-ivacaftor on anxiety and depression screening scores after 6 months of treatment

477 Assessing the impact of elexacaftor-tezacaftor-ivacaftor on anxiety and depression screening scores after 6 months of treatment

Improving Anxiety and Depression in Pregnant Mothers Participating in Nurse Home Visitation.

The perinatal period is a time of significant adjustment for mothers, which may lead to alterations in mood that affect maternal mental health, which may also impact child development. The current article details the effectiveness of the addition of a psychiatric-mental health nurse practitioner (PMHNP) and mental health training for nurses on the anxiety and depression screening scores of mothers enrolled in a home visitation program. For clients with elevated anxiety and depression scores, the percentages of those who were referred to and received mental health services increased after the program's addition of the PMHNP and mental health training. Implications for future research and practice include continued focus on maternal mental health with improved access to assessment and treatment for all clients within home visitation. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 49-55.].

Perinatal Depression Screening Among Sexual Minority Women

A substantial number of births in the US are to sexual minority women (17% based on a nationally representative survey), yet there is little research on perinatal depression screening rates or symptom endorsement among sexual minority women (including women who identify as lesbian, bisexual, queer, pansexual, asexual, demisexual, and kinky as well as other-identified women who have sex with women). High rates of risk factors for perinatal depression (eg, intimate partner violence and history of mental illness) among sexual minority individuals magnify this gap in the literature. To describe the prevalence of female-identified sexual minority people giving birth in an academic medical center and compare perinatal depression screening rates and scores among sexual minority women and heterosexual cisgender women. This retrospective cohort study used deidentified medical record review of 18 243 female-identified individuals who gave birth at an academic medical center in Chicago, Illinois, between January 1 and December 31, 2019. Data were analyzed from April 5, 2021, to August 1, 2022. Proportion of women identified as having sexual minority status in the medical record, rates of standard care administration of the 9-item Patient Health Questionnaire between sexual minority women and heterosexual women, and depression screening scores and rates of positive depression screening results for sexual minority and heterosexual women. Among 18 243 women (mean [SD] age, 33.8 [5.1] years; 10 453 [57.3%] of non-Hispanic White race and ethnicity), only 280 (1.5%; 95% CI, 1.3%-1.7%) were identified as having sexual minority status in the medical record. Significantly more sexual minority women vs heterosexual women attended at least 1 prenatal care visit (56 [20.0%] vs 2459 [13.7%]; P = .002) and at least 1 postpartum care visit (52 [18.6%] vs 2304 [12.8%]; P = .004). Sexual minority women were more likely to be screened for depression during postpartum care (odds ratio, 1.77; 95% CI, 1.22-2.52; P = .002) and more likely to screen positive for depression during the postpartum period (odds ratio, 2.38; 95% CI, 0.99-5.02; P = .03) than heterosexual women. In this cohort study, sexual minority women identified in the medical record were highly engaged in obstetric care yet at high risk of postpartum depression. In addition, their sexual orientation was largely undocumented in medical records. These results highlight the need for investigations that include strategies for measuring sexual orientation because medical record review is unlikely to reliably capture these sexual identities during the perinatal period.

Depression Screening Scores and Allergy and Gastrointestinal Medication Use in Adolescents.

Between 2005 and 2014, the 12-month prevalence of major depressive episodes among adolescents aged 12 to 17 years increased from 8.5% to 11.3%. Adolescent-onset depression is related to increased risk for depression and suicidal attempts in adulthood. It is known that depression is an adverse effect among adults taking OAM; however, the effect of OAM on adolescents is unknown. The aim of this study was to describe the relationship between Patient Health Questionnaire 9- Modified (PHQ9-M) scores and OAM use among adolescents. This study included data abstracted from charts of adolescents aged 12 to 21 years who completed a Kansas Be Healthy wellness appointment at the KUSM-W Peds Clinic in 2017. Odds ratios were used to calculate the relationship between oral allergy medication and gastrointestinal medication use among adolescents and PHQ9-M scores. Of the 425 adolescent charts analyzed, 22% (n=96) had positive PHQ9-M screens (a score of 10 or greater), and 13% (n=56) reported current use of allergy medication and/or GI medications. Adolescents taking oral allergy medication were 1.77 times more likely to have a positive PHQ9-M screen than those not taking oral allergy medication. Among adolescents on allergy medication, there was no difference in PHQ9- M scores based on the drug class (1^st or 2<up>nd</sup> generation antihistamine or Montelukast). Healthcare providers must diligently explore OAM/GI use with adolescents during clinical encounters and discuss possible adverse effects of OAM on mood.

A Prospective Study of Social Needs Associated with Mental Health among Postpartum Patients Living in Underserved Communities.

Given the rising rates of maternal morbidity and mortality in the United States and the contribution of mental illness, especially among individuals living in underresourced communities, the objective was to evaluate the prevalence of unmet health-related social needs and their impact on perinatal mental health outcomes. This was a prospective observational study of postpartum patients residing within regions with increased rates of poor perinatal outcomes and sociodemographic disparities. Patients were enrolled in a multidisciplinary public health initiative "extending Maternal Care After Pregnancy (eMCAP)" between October 1, 2020 and October 31, 2021. Unmet health-related social needs were assessed at delivery. Symptoms of postpartum depression and anxiety were evaluated at 1 month postpartum utilizing the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD7) screening tools, respectively. Mean EPDS and GAD7 scores and odds of screening positive (scoring ≥ 10) were compared among individuals with and without unmet health-related social needs with p < 0.05 considered significant. Of participants enrolled in eMCAP, 603 completed at least one EPDS or GAD7 at 1 month. Most had at least one social need, most commonly dependence on social programs for food (n = 413/603; 68%). Individuals lacking transportation to medical (odds ratio [OR]: 4.0, 95% confidence interval [CI]: 1.2-13.32) and nonmedical appointments (OR: 4.17, 95% CI: 1.08-16.03) had significantly higher odds of screening positive on EPDS while participants lacking transportation to medical appointments (OR: 2.73, 95% CI: 0.97-7.70) had significantly higher odds of screening positive on GAD7. Among postpartum individuals in underserved communities, social needs correlate with higher depression and anxiety screening scores. This highlights the need to address social needs to improve maternal mental health. · Social needs are prevalent among underserved patients.. · Needs can be assessed in a structured or freeform manner.. · Unmet needs correlate with poor mental health outcomes.. · Similar needs correlate with depression and anxiety..

Abstract P6-05-34: Depression and Psychological Distress in Breast Cancer Patients

Abstract Introduction: Patients with breast cancer are at increased risk for depression and suicide compared to the general population. Breast cancer is unique among other cancers in that some treatments aim to decrease levels of estrogen, a hormone that is intricately linked to mood regulation. The trauma of diagnosis, invasive treatments, and hormone dysregulation all possibly contribute to poor mental health outcomes. Understanding risk factors associated with depression and distress are important for timely interventions. Methods: We performed a retrospective chart review of breast cancer patients seen at Froedtert &amp; MCW Cancer Center Breast Care Clinic between 2019 and 2020. The present study had two aims. The primary aim was to identify breast cancer patient populations at increased risk of depression and psychological distress. Patient populations were distinguished by tumor pathology, patient demographics, and types of treatment interventions. The secondary aim was to identify demographic and clinical variables associated with changes in self-reported distress and depression. Univariate and multivariate analysis of demographic and clinical variables was performed in relation to Patient Health Questionnaire (PHQ) and The National Comprehensive Cancer Network (NCCN) Distress Thermometer scores. Results: Data from 197 patients was analyzed. Patients with a history of depression scored significantly higher on distress screening (mean= 4.4  3.0, p=0.004) versus patients without psychiatric history (mean 2.8  2.9). Patients under 50 years old reported higher levels of distress than patients over 70 years old (p=0.031, beta= -1.0). Self-reported distress declined significantly with increased time from initial diagnosis (p=0.043; p=0.006 at 2 years). Distress was significantly higher prior to initiation of radiation versus during and immediately following therapy (p=0.028). A history of depression, younger age, passage of time, and temporal relationship to radiation treatment were not associated with significant differences in self-reported depression on multivariate analysis. Distress and depression screening scores were not significantly impacted by surgery or chemotherapy (p=0.5; p=0.11 respectively). Conclusion: Patients with a known history of depression and age less than 50 reported significantly higher levels of distress but not depression associated with diagnosis of breast cancer. Distress exhibited a greater downward trend than depression following initiation of oncologic intervention. The results of this study indicate that breast cancer patients are susceptible to significant fluctuations in psychological distress. In contrast, clinically relevant depression screening scores were less frequent and less subject to deviation. Table 1. Multivariate analysis. Citation Format: Kelly R. Cotchett, Adam H. Kelly, Aniko Szabo, Yee Chung Cheng, Sailaja Kamaraju, Christopher Chitambar, Lyndsey Wallace, Lubna N. Chaudhary, John Burfeind. Depression and Psychological Distress in Breast Cancer Patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-34.