PHQ-9 Screening Research Articles

Post-COVID cognitive impairment, level of depression and anxiety in university students

Recently, a significant amount of research has focused on the impact of COVID-19 on mental health. One of the increasingly common long-term consequences of COVID-19 is its effect on cognitive function, even in patients with an initially mild course of the acute illness. The article presents the results of a study of cognitive impairment and anxiety and depression levels among students of a higher medical educational institution. The study consisted of a continuous screening survey of students who had and had not experienced COVID-19 using an original questionnaire, as well as psychometric scales: Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Based on the screening results, two groups were formed (those who had COVID-19 and those who did not), and a comparative analysis was carried out. It was found that a third (32.4%) of young people who had COVID-19 developed cognitive impairment. In students who were not ill, cognitive impairment was detected half as often – 16.8%. It was revealed that regardless of the fact of having suffered an infectious disease, a quarter of students experienced increased anxiety and decreased mood. Affective experiences, in turn, negatively affected cognitive functioning and caused young people to be more attentive to their health, including mental health, which was accompanied by a large number of positive responses when using the PHQ-9 and GAD-7 screening questionnaires.

Sensitivity and specificity of Aboriginal-developed items to supplement the adapted PHQ-9 screening measure for depression: results from the Getting it Right study.

To determine the psychometric properties of an Aboriginal and Torres Strait Islander-developed depressive symptom screening scale. Prospective diagnostic accuracy study. Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. 500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. Criterion validity of seven Aboriginal and Torres Strait Islander-developed items, using the adapted Patient Health Questionnaire 9 (aPHQ-9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. The seven-item scale had good internal consistency (α=0.83) and correlated highly with the aPHQ-9 (ρ=0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ-9 when compared with the MINI-identified diagnosis of a current major depressive episode. Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts.

Influencia de los factores socioeconómicos y psicológicos en los resultados del tratamiento quirúrgico de la artrosis trapecio-metacarpiana

ObjectiveThis study aimed to investigate to what extent people with carpometacarpal thumb osteoarthritis that are socioeconomically disadvantaged and have psychological disorders report higher pain levels and worse patient-rated upper-extremity functionality after surgical treatment. Material and methodA single center, retrospective observational cohort study analysing 100 patients diagnosed with thumb carpometacarpal osteoarthritis between 2013 and 2019. Patients were divided into two groups (50/50), depending on whether they received surgical or conservative treatment. The socio-economic status (ESeC classification) and presence of psychological comorbidities were investigated. Functional outcomes were assessed using the Visual Analogue Scale (VAS), Q-DASH questionnaire and Kapandji score. Current mental disorders were evaluated using STAI, PHQ-9 and PCS screening scales. ResultsMeasures of functional hand scores (Q-DASH) were higher and had considerably less pain in surgically treated participants, although thumb mobility (Kapandji) was more restricted. They were also associated with higher scores on psychological assessment scales. Sixty-four per cent of the patients came from lower socio-economic classes and suffered from poorer scores on the mental health screening questionnaires. Of the patients manage surgically, 54% were diagnosed of dysthymic disorder and showed significantly worse patient-rated upper-extremity function (Q-DASH questionnaire, median [IR]:31,8 [20,5-54,6] than patients without psychological disorders (median [IR]: 13,6 [2,3-36,5]). No differences were found for patients with and without disthymic disorder managed nonoperatively. ConclusionsPatients with higher rates of depression, anxiety and pain catastrophizing behaviour showed significantly worse outcomes after surgery for osteoarthritis of the first carpometacarpal joint. Lower socio-economic class significantly influences levels of depression and anxiety but did not affect functional outcome. Surgical treatment of carpometacarpal thumb osteoarthritis achieved better self-perceived hand function (QDASH, VAS, Kapandji) than conservative treatment.

Evaluation of Depression and Its Correlates in Terms of Demographics, Eating Habits, and Exercises Among University Students: A Multicenter Cross-Sectional Analysis.

University students are a vulnerable population prone to mental health challenges. This study aimed to investigate depression and its associated factors among university students in terms of demographics, eating habits, and exercises. A total of 2891 university students from three universities participated in this study between January 2024 and February 2024. An online survey questionnaire was distributed using a snow-ball strategy. The survey collected demographic, lifestyle, and psychological data, including depression and anxiety scores using the PHQ-9 and GAD-7 screening tools. Subgroup analysis was conducted according to sport frequency and sport type using Chi-square test for qualitative data and t-test for quantitative data. Multiple linear regression analysis was performed to identify risk factors for depression. A total of 44.2% and 39.5% of the participants reported symptoms of depression and anxiety, respectively. Significant differences were observed in various characteristics across different sport frequency groups, with participants with higher sport frequency tending to have less depression (P<0.001) and anxiety (P<0.001) symptoms. As the frequency of weekly exercise increased, anxiety and depression scores gradually decreased. The mean PHQ-9 and GAD-7 scores were highest in the group with no sports and lowest in the group with a sport frequency of 3-4 times per week (P<0.001). Additionally, once exercise frequency reached 5 times per week or more, anxiety and depression scores no longer decreased. Subgroup analysis based on sport type revealed that participants engaging in specific sports, such as basketball, tennis, dance, and running, had lower depression (P<0.001) and anxiety (P<0.001) scores compared to the overall average. Based on multiple linear regression analysis, married status (P=0.036), enjoying barbecue food (P<0.001), prolonged sedentary time (P=0.001), experiencing stress events (P<0.001), and electronic device usage time (P<0.001) were positively associated with depression scores, while loving eating vegetables (P=0.007), a relatively longer sport time (P=0.005), a higher exercise frequency (P=0.064), and no chronic disease (P<0.001) were negatively associated with depression scores. This study highlights the importance of a healthy lifestyle, including regular exercise, limited exposure to electronic screens, and a balanced diet, in preventing and mitigating depression among university students. This study also suggests that exercising 3-4 times a week is associated with the lowest levels of anxiety and depression. Activities such as basketball, tennis, dance, and running are effective in alleviating these mental health issues through regular exercise.

Lack of Association Between Depression and Subclinical Hypothyroidism in Adolescents Presenting for Routine Physical Examinations.

There are conflicting results in the existing studies regarding the association between depression and subclinical hypothyroidism in adolescents. Subclinical hypothyroidism is defined as elevated thyroid stimulating hormone (TSH) levels above the reference range without signs or symptoms of hypothyroidism. The focus of this study is to determine whether there is any association between depression and subclinical hypothyroidism, (as defined by the serum TSH levels) in a population of healthy adolescents. Quantitative-based cross-sectional study of a representative subset of the adolescent population. We carried out a cross-sectional study to determine the association between major depressive disorder (MDD) and subclinical hypothyroidism, in adolescents presenting for annual physical examinations during the peak period of the COVID-19 pandemic in the USA, a period deemed high for adolescent depression. All the adolescents were screened for depression by the PHQ-9 screening tool and had their TSH measured. Of the 304 subjects analyzed, 179 (58.88%) were minimally or not depressed according to the Patient Health Questionnaire (PHQ-9) screening tool (mean PHQ 1.80 ± 1.49). 70 (23.03%) had mild depression (mean PHQ 6.59 ± 1.46), 50 (16.45%) had moderate depression (mean PHQ 13.70 ± 2.75), and 5 (1.64%) had severe depression (mean PHQ 21.40 ± 1.67). Mean TSH values were 1.93 ± 0.99, 1.77 ± 1.05, 2.10 ± 0.98, and 1.57 ± 0.32 mIU/L, respectively in the four groups. All values were within the recommended range of 0.50 to 4.30 mIU/L, without statistically significant inter-group differences. We conclude that there is no statistically significant association between depression and subclinical hypothyroidism, in a population of adolescents presenting for physical examinations, and if the screening for depression by the PHQ-9 tool indicates depression, a screening TSH test for subclinical hypothyroidism is not justified.

The Mental Health Implications of Obstetric Brachial Plexus Injuries (OBPI) on Parents.

Obstetric brachial plexus injuries (OBPI) can have mental health implications on parents coping with this injury to their newborn. The purpose of this study was to assess the mental health of mothers with newborns with an OBPI and identify resources that can help screen and treat mental health needs. Three groups of mothers were prospectively given a self-reported survey: 1) Newborns with OBPI; 2) Newborns in the nursery without OBPI; 3) Newborns in the neonatal intensive care unit (NICU). The survey consisted of demographic questions, the PHQ-9 and PCL-S screening tools, and parents' exposure to community violence, family support and use of drugs or alcohol. Fifty-seven mothers were prospectively enrolled, and 30% (17/57) of mothers screened in for post-traumatic stress disorder (PTSD). OBPI mothers had significantly higher rates of PTSD symptoms when compared to mothers of children in the full-term nursery (difference = 36.4%; p < 0.01). No statistically significant difference was found between groups regarding depression symptoms. OBPI can be very difficult to cope with for parents and family members. Forty-two percent of mothers with newborns with OBPI or children in the NICU screened in for PTSD symptoms. OBPI clinics should be staffed similarly to the NICU with clinical social workers to appropriately screen and treat parents with PTSD and depression symptoms.

Public Awareness and Prevalence of Depression Symptoms among Patients Attending Primary Health Care Centers in Qatar

Background: Public awareness is a key element in the management of depression, public awareness campaigns have contributed to the improvement of public knowledge attitudes, and to reduction of stigma towards depression.&#x0D; Aim: The aim is to identify public awareness towards depression and to estimate prevalence of depression among participants&#x0D; Methods: Descriptive cross-sectional study, this study was conducted in (West Bay Health Center, Al-Rayan Health Center and Al-Dayen Health Center) affiliated to Primary Health Care Corporation in Qatar, it included all selected patients attending three randomly chosen health centers, with total response rate representing 82 % with total sample size 316 participant conducted during from January to March 2021, self-administered validated questionnaire including basic demographic data, awareness about symptoms of depression, risk factors, attitudes, treatment and help seeking behaviors also completing the PHQ-9 screening for depression questionnaire.&#x0D; Results: The general awareness about depression among participants lies within the range of 48% to 95.7%, participants attitudes towards depression revealing that good attitudes regard willing to work with depressed people (88.9%) and willing to make friends with them ( 82% ) while 39.4% agree to marry from them, participants preferences regard whom to seek advice regard depression revealing that in order psychologist (89.1%) then psychiatrist (87.8%) while family physicians (66.7%), PHQ-9 score among participants revealing average prevalence of depression reaching 19.7% at the cut point score of 10 with males reaching 17% and females 20.7%.&#x0D; Conclusions: Generally, in Qatar the level of public awareness of depression among participants was acceptable and they had positive attitudes towards depressed people also there is some statistical significant awareness results related to females in comparison to males. However, further efforts must be done to build public health educational programs related to depression in order to further raise its awareness in the community.

Co-occurrence of PTSD and affective symptoms in a large sample with childhood trauma subtypes: A network analysis.

Exposure to childhood trauma (CT) is associated with various deleterious mental health outcomes, increasing the risk of suicidal behaviors. The objective of this study is to investigate the different effects of three forms of CT, including emotional abuse (EA), physical abuse (PA), and sexual abuse (SA), on potential psychopathological symptoms among college students. A total of 117,769 students from 63 Chinese colleges participated in this study. There were 1,191 participants in the EA group (1.24%; 95% CI: 1.17-1.31%), 1,272 participants in the PA group (1.32%; 95% CI: 1.25-1.40%), and 3,479 participants in the SA group (3.62%; 95% CI: 3.50-3.73%). CT was measured by the Childhood Trauma Questionnaire-Short Form. Psychopathological symptoms (i.e., depression, anxiety, and PTSD) were measured by the PHQ-9, GAD-7, and Trauma Screening Questionnaire, respectively. Network analysis was applied to analyze psychopathological symptoms between three CT subgroups (EA, PA, and SA). The associations and centralities of the networks were calculated, and the network characteristics of the three subgroups were contrasted. The main symptoms across all three groups are uncontrollable worry, sad mood, irritability, and fatigue, which indicates these core symptoms play essential roles in maintaining the whole psychological symptoms network. Furthermore, there are significant differences in symptom associations between the three groups. The comparison of network structures of the three groups shows that the SA group reports more PTSD symptoms, the EA group reports more suicide-related symptoms, and the PA group reports more anxiety symptoms. Specific symptoms were disclosed across each group by the distinctive core psychopathological symptoms found in the CT subgroup networks. The present study's findings show different associations between CT and psychopathology and may help classify potential diagnostic processes. Therefore, local governments and academic institutions are recommended for early intervention to promote the psychological well-being of CT survivors.

Machine Learning Model for Computer-Aided Depression Screening among Young Adults Using Wireless EEG Headset.

Depression is a disorder that if not treated can hamper the quality of life. EEG has shown great promise in detecting depressed individuals from depression control individuals. It overcomes the limitations of traditional questionnaire-based methods. In this study, a machine learning-based method for detecting depression among young adults using EEG data recorded by the wireless headset is proposed. For this reason, EEG data has been recorded using an Emotiv Epoc+ headset. A total of 32 young adults participated and the PHQ9 screening tool was used to identify depressed participants. Features such as skewness, kurtosis, variance, Hjorth parameters, Shannon entropy, and Log energy entropy from 1 to 5 sec data filtered at different band frequencies were applied to KNN and SVM classifiers with different kernels. At AB band (8-30 Hz) frequency, 98.43 ± 0.15% accuracy was achieved by extracting Hjorth parameters, Shannon entropy, and Log energy entropy from 5 sec samples with a 5-fold CV using a KNN classifier. And with the same features and classifier overall accuracy = 98.10 ± 0.11, NPV = 0.977, precision = 0.984, sensitivity = 0.984, specificity = 0.976, and F1 score = 0.984 was achieved after splitting the data to 70/30 ratio for training and testing with 5-fold CV. From the findings, it can be concluded that EEG data from an Emotiv headset can be used to detect depression with the proposed method.

Depression screening and use of supportive care services in prostate cancer.

219 Background: Patients with prostate cancer (PC) have high rates of depression (15-20%), which is associated with worse oncologic outcomes. The PHQ-9 is commonly used in depression screening, but men with depression may present differently than women, and male-specific screening tools such as the Gotland Male Depression Scale (GMDS) have also been developed and validated. The use of supportive care services in men with PC and depression is not well-described. Methods: Men with ≥1 Urology or Medical Oncology clinic visit for PC in the prior 6 months were emailed the PHQ-9 and GMDS every 60 days. Men who screened positive (score ≥10 on PHQ-9 or ≥13 on GMDS, consistent with moderate to severe depression) were contacted by phone to discuss the positive screen; during that conversation patients were offered a referral to an oncology social worker for a formal needs assessment and connection to supportive care services. Patient characteristics and use of supportive care services (palliative care, psychiatry, counseling, support groups, or spiritual health) at baseline and as a result of study screening were collected by survey and chart review. Results: Between 6/2021-12/2021, 201 men enrolled (Table). 184 completed ≥2 screens with mean follow-up 6.5 months (SD 1.3). 31 men (15.4%) had ≥1 positive PHQ-9 screen and 11 (5.5%) had ≥1 positive GMDS screen, 9 of whom also screened positive on the PHQ-9. Of the 33 men offered clinical social work referrals based on PHQ-9 or GMDS screening, 12 (36%) initially accepted and 7 (21%) ultimately met with social work. Of these 7 men, two ultimately received ongoing supportive counseling from social work, two were referred to support groups or peers in the community, and one was referred to financial services; the remaining two men were not followed longitudinally or referred to any services by the social worker, but were given the option to re-contact the social worker as needed. For the two patients who screened positive on the GMDS but not the PHQ-9, one declined social work referral, and one initially accepted but never scheduled an appointment. Conclusions: Use of supportive care services in men with PC was low, including when services were actively offered as a result of depression screening. Beyond the PHQ-9, the GMDS did not identify any men who engaged in supportive care services. More work is needed to optimally identify men with PC who may benefit from supportive care services and barriers to use.[Table: see text]

Depression Screening and Behavioral Health Integration in Musculoskeletal Trauma Care.

To report our experiences in implementing a behavioral health integration pathway, including a validated depression screening and referral to care. Retrospective case series. Single surgeon's musculoskeletal trauma outpatient practice during calendar year 2019. All patients presenting to the practice during 2019 were included (n = 573). We piloted the usage of Patient Health Questionnaire (PHQ)-2 and PHQ-9 screening. An evidence-based, real-time treatment protocol embedded in the electronic health record was triggered when a patient screened positive for depression including an automated behavioral health integration pathway. The percentage of patients screened, the results of the PHQ screening, and the number of patients referred and enrolled in behavioral health programs were collected. Of the 573 patients, 476 (83%) received the PHQ-2 screening, 80 (14%) had a current screening on file (within 1 year), and 17 (3.0%) were not screened. One hundred seventy-two patients (36%) had a PHQ-2 score of 2 or greater and completed the PHQ-9; of them, 60 (35% of patients screened with full PHQ-9, 13% of patients screened) screened positive for symptoms of moderate depression (PHQ-9 score ≥10), and 19 (4.0%) reported passive suicidal ideation (PHQ-9 item 9). Fifty of these patients were referred to behavioral health through the pathway, and 8 patients enrolled in the program. Ten patients were not referred because of a technical error that was quickly resolved. Patients reporting suicidal ideation were managed with psychiatric crisis resources including immediate virtual consult in the examination room. This case series demonstrates the feasibility of screening patients for depressive symptoms and making necessary referrals to behavioral health in outpatient musculoskeletal trauma care. We identified 50 patients with depression and appropriately triaged them for further care in our community.

Impact of the COVID-19 Pandemic on Mental Health Conditions of COVID-19 Survivors of the Academic Community of Duta Wacana Christian University

The Coronavirus-19 (Covid-19) pandemic had a significant impact on all aspects of human life. The purpose of this study was to obtain an overview of the mental health impacts caused by the COVID-19 pandemic on Dutawacana Christian University (UKDW) academic community. The research design used was cross-sectional, data collection was conducted online using the SRQ-29 and PHQ-9 screening questionnaires. The demographic data of this study indicate that majority of respondents are women (72.2%). Minimum age 19 years, maximum 42 years with a mode of 20 years. The income level is mostly below IDR 5,000,000 per month. The number of family members living in the same house is less than 5 people,married 50%. The results of screening with the SRQ-29 showed 44.4% neurosis; 33.3% psychotic; 55.6% PTSD symptoms. Screening with the PHQ-9 instrument showed 22.2% mild and moderate symptoms of depression; while for moderate-severe and severe depressive symptoms was 5.6%. Depression and anxiety in female survivors were higher than men. As conclusion, COVID-19 pandemic has had a psychological impact on survivors in the UKDW academic community, including the tendency to experience symptoms of depression, psychotic and traumatic experiences.

Improving Depression Screening in Primary Care.

Depression is a serious problem in the United States. It not only impacts chronic illness and healthcare utilization, but it can also result in death, intentional or unintentional. Despite the seriousness associated with depression, it continues to be underdiagnosed and undertreated. The primary care setting provides an ideal location to screen and initiate treatment for depression in individuals who would otherwise not be screened. The objective of this evidence-based practice project was to improve the diagnosis and treatment of depression in an adult primary care office. An intervention consisting of a HealthWatcher reminder for depression screening, the administration of the PHQ-9 instrument, and a treatment algorithm was incorporated into the office workflow. The charts of a pre-intervention random sample were compared to a post-intervention random sample to test for significant differences in depression screening and treatment rates. Using the chi-squared test, the post-intervention sample screening rate was significantly higher than pre-intervention sample rate (90% vs 23.3%; χ2 = 54.3, df = 1, P < .000). It is feasible to improve the diagnosis and treatment of depression for adult primary care patients by modifying office protocols and using the PHQ-9 screening instrument and a treatment algorithm.

Distinguishing the Effect of Time Spent at Home during COVID-19 Pandemic on the Mental Health of Urban and Suburban College Students Using Cell Phone Geolocation.

The aim of this study was to assess the correlation of depression and anxiety with time spent at home among students at two universities—one urban and the other suburban—during the COVID-19 pandemic. Methods: Geolocation data from the smartphones of 124 participants were collected between February 2021 and May 2021. The level of depression was estimated by the PHQ-9 and PHQ-2 screening tools, and anxiety scores were estimated by the GAD-2 and GAD-7 screening tools. Results: 51% of participants in the PHQ-9 surveys indicated mild to severe depression. Participants spent on average 75% of their time at home during COVID. Time spent at home had a positive correlation with the mental health of urban students but a negative correlation with suburban students. The relation between the time at home with mental health was stronger among female participants than among male participants. Correlations between female depression, anxiety, and time at home were significant. Conclusions: Lockdown and distance learning contributed to the high levels of depression in university students. This research highlights the importance of time spent at home for mental health being during the pandemic and the importance of distinguishing between urban and suburban settings when formulating public health recommendations. Quality of time spent at home versus time spent outside differentiated the mental well-being of students located in different environments. Staying at home may be recommended for students without access to safe outdoor places as it is associated with lower levels of depression.

Depression and eating disorders among health care professionals in Morocco during the COVID-19 pandemic

Introduction: In Morocco, the first confirmed case of COVID-19 was on March 2nd, 2020. On March 11, 2020, the World Health Organization announced the outbreak of COVID-19 to be a pandemic. Due to the subsequent increase in confirmed cases in Morocco, a state of medical emergency with lock down was declared on March 20th, 2020. Pandemics, such as COVID-19, may lead to or further exacerbate psychological distress. The pandemic’s impact on mental health and eating disorders among health care professionals in Morocco is unknown. The aim of this study was to screen for depression and eating disorders among healthcare workers in Morocco during the COVID-19 pandemic. Methods: An anonymous self-administered questionnaire was distributed to a sample of Moroccan healthcare workers via an online platform. The questionnaire included the SCOFF and PHQ-9 screening tools to assess for the presence of depression and eating disorders. A total of 389 questionnaires were completed. Results: Of the participants, 29.3% had moderate to severe depression. Females and older participants had statistically significant higher rates of depression (p=0.012, 0.000, respectively). Eating disorders were present in 42% of our sample. The presence of an eating disorder was more likely among participants that were younger (<22 years old, p=0.01), obese (p=0.009), using cannabis (p=0.009), emotional eating (p<0.001) or diagnosed with depression (p=0.001). Conclusion: The pandemic has negative impacts on mental health and eating behaviors among a sample of Moroccan health care workers. Compared to the pre-pandemic period, both rates of depression and eating disorders increased. This supports the need for increasing access to mental health services among healthcare professionals in Morocco as well as reducing the stigma associated with getting help.

135-LB: Implementation of Depression Screening in a Pediatric Diabetes Clinic with Limited Mental Health Support

Objective: Depression is common in adolescents with type 1 (T1D) and type 2 diabetes (T2D) , and for those with T1D, is associated with suboptimal health outcomes, including higher A1c levels and increased rates of hospitalizations. The ADA standards of care recommend integration of depression screening into routine medical care, but follow-up for positive screens is challenging in settings with limited mental health support. Here, we describe our latest PDSA cycle results from a quality improvement (QI) project for implementing depression screening in adolescents with diabetes. Methods: This QI project took place in a pediatric diabetes center without access to mental health support as part of routine diabetes care. Our goals were to 1) increase depression screening via the PHQ-9 from 0% to 80% over 2 years in all patients with T1D or T2D &amp;gt;11 yrs old and 2) refer 100% of patients who screened positive to behavioral health by the end of the 2-year period (Dec 2019-Dec 2021) . Our QI project included 4 Plan-Do-Study-Act (PDSA) cycles ranging from trialing PHQ-9 screening with a single provider (Cycle 1) to implementing screening across all providers (Cycle 4) . This abstract focuses on the last 6 months of PDSA Cycle 4 (previous cycles were presented at 2021 ADA Scientific Sessions) . Results: From July-Dec. 2021, a total of 68% of eligible patients completed PHQ-9 screening. Screening rates ranged from 46-90% across 5 different providers; 2 providers achieved screen rate goal of &amp;gt;80%. Of the 68%, 28% screened positive and 86% of them were referred to behavioral health. Referral rates for positive screens ranged from 83-100% per provider; 2 providers achieved refer rate goal of 100%. Conclusions: Although we did not achieve our PHQ-9 screen rate goal of 80% or our behavioral health refer rate goal of 100% by the end of 2 years, we found a major discrepancy in rates among providers. This prompted us to add an additional PDSA Cycle 5, which focuses on improving screening and refer rates for all providers. Disclosure S. Gurnurkar: None. A. Y. Kulasingham: None. J. Pierce: None.

Prevalence of alcohol use disorder among the Latvian general population and associations with the PHQ-9 screening results and sociodemographic factors

IntroductionBoth alcohol use disorder (AUD) and depression are potentially disabling and economically burdensome disorders. There is no available information about the prevalence of alcohol use disorder in the general population of Latvia.ObjectivesTo determine the 12-month prevalence of AUD and the association with depressive symptoms and socio-demographic factors among the Latvian general population.MethodsComputer assisted face-to-face interviews were carried out in 2019-2020 among a representative sample of the Latvian adult population (n=2687). The study sample was selected using a stratifyed random sampling method. The respondents were interviewed using the Patient Health Questionnaire-9 (a score of ≥10 was defined as indicating the presence of a clinically relevant depressive symptoms) and the Mini-International Neuropsychiatric Interview. Descriptive statistics and Chi-square test was applied.ResultsThere were 1238 males (46.1%) and 1449 females (53.9%) recruited. Mean age of respondents was 49.9 (SD 18.2). The 12-month prevalence of AUD according to the M.I.N.I was 13.1% with a statistically significant difference between the genders: 23.6% in men and 4.1% in women (p&lt;0.001). AUD was significantly more prevalent among the respondents younger than 40 years: 18.0% (p&lt;0.001), especially among young (18-44 y.o.) men – 28.1% of all diagnosed cases (p&lt;0.001); There was found an association between the severity stage of AUD and PHQ-9 screening results: 18.8% of those diagnosed with severe AUD had a score greater than 10 points in the PHQ-9 (p&lt;0.001).ConclusionsYoung men are at particularly high risk of alcohol use disorder. Those with diagnosed alcohol use disorder should be also screened for the depressive symptoms.DisclosureNo significant relationships.

Improving Depression Screening in Primary Care.

Depression is a serious problem in the United States. It not only impacts chronic illness and healthcare utilization, but it can also result in death, intentional or unintentional.Despite the seriousness associated with depression, it continues to be underdiagnosed and undertreated. The primary care setting provides an ideal location to screen and initiate treatment for depression in individuals who would otherwise not be screened. The objective of this evidence-based practice project was to improve the diagnosis and treatment of depression in an adult primary care office. An intervention consisting of a HealthWatcher reminder for depression screening, the administration of the PHQ-9 instrument, and a treatment algorithm was incorporated into the office workflow. The charts of a pre-intervention random sample were compared to a post-intervention random sample to test for significant differences in depression screening and treatment rates. Using the chi-squared test, the post-intervention sample screening rate was significantly higher than pre-intervention sample rate (90% vs 23.3%; χ2 = 54.3, df = 1, P < .000). It is feasible to improve the diagnosis and treatment of depression for adult primary care patients by modifying office protocols and using the PHQ-9 screening instrument and a treatment algorithm.

Geriatric Depression and Variables in Residential Homes Located around Religious Beliefs Tagged Land Area

Depression is one of the psychiatric problems in geriatric population with a decrease in wellbeing. There was few prevalence studies carried out in old age residential homes located around spiritual and religious beliefs’ tagged area. This study was to find prevalence of depression and its associations in residents of old-age homes located around spiritual and religious beliefs’ tagged area. A cross-sectional study was carried out in four residential homes with face-to-face interviews using validated GDS-15 and PHQ-9 Nepali version questionnaires. Data were analyzed using percentage, mean, univariate analysis and logistic regression. Among a total of 108 respondents, GDS-15 screening detected 36.2% of residents to be depressed (cut-off 4/5) and PHQ-9 screening detected 37.1% to be depressed (cut-off 4/5). The mean age was 75.7 years (± 8.3). Two-thirds of residents were female and the majority follow Hinduism religion. The majority were illiterate and were farmers in past. Odds of having depression decreases by 92% in self-reported better-satisfied status compared to unsatisfied status and by 89% in self-reported better-financed status compared to worse financed status. Geriatric depression is low in old age homes located around areas tagged with religious and spiritual beliefs. However further comparative study is required to find a correlation of depression with spirituality and religiousness in daily social living. Depression decreases more with self-satisfaction of old age people rather than financial stability.

AACE2021-A-1079: Screening for Depression Among Patients with Diabetes in an Outpatient Diabetic Clinic at a Tertiary Care Hospital in Saudi Arabia

Depression is a highly prevalent and severe medical condition with a lifetime occurrence, in the range of around 11% in economically low-income countries to 15% in high-income countries. In this study, we aimed to screen the depression level among patients with diabetes in Saudi Arabia. This cross-sectional study was conducted among 112 (age range 18-75yrs) patients with diabetes at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. The depression level was measured using two psychological screening scales, the World Health Organization Well-being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). In addition to screening the depression, demographic variables, glycated hemoglobin (HbA1c), diabetes-related complications, type of medications used for treatment were also collected. According to the WHO-9 screening scale, male patients, ≥ 40 yrs age group, patients on the insulin pump, having diabetes for ≥ 10 yrs and patients with microvascular complications showed a high level of depression compared to their counterparts. According to the PHQ-9 screening scale, unmarried patients and patients on insulin pump showed a high level of depression compared to their counterparts. The findings of the study could be of immense assistance to the healthcare systems, educational institutions, researchers, and government to develop evidence-based programs, policies, and guidelines towards increasing the knowledge and awareness about depression among diabetes so that early detection and management can be ensured to control the increasing burden of depression among patients with diabetes in Saudi Arabia.