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Citation
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Hamdan SZ, Davis M, Faig W, Guthrie W, Yerys BE, Wallis KE. Acad. Pediatr. 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine rates of depression screening and positivity among autistic adolescents where electronic depression screening is administered universally; to compare rates between autistic and non-autistic youth; and to explore sociodemographic and clinical factors associated with screening completion and results.
METHODS: We conducted a retrospective cohort study comparing 12-17-year-old autistic and non-autistic adolescents presenting for well-child care in a large pediatric primary care network between November 2017 and January 2019 (N=60,181). Sociodemographic and clinical data, including PHQ-9-M completion status and results, were extracted digitally from the electronic health record and compared between autistic and non-autistic youth. Logistic regression explored the relationship between sociodemographic and clinical factors and screen completion and results, stratified by autism diagnosis.
RESULTS: Autistic adolescents were significantly less likely to have a completed depression screen compared to non-autistic adolescents [67.0% versus 78.9%, Odds Ratio (OR)=0.54, p<0.01]. Among those with a completed screen, a higher percentage of autistic youths screened positive for depression (39.1% versus 22.8%; OR=2.18, p<0.01,) and suicidal ideation/behavior (13.4% versus 6.8%; OR=2.13, p<0.01). Factors associated with screening completion and positivity differed between autistic and non-autistic groups.
CONCLUSION: Autistic adolescents were less likely to have a completed depression screen when presenting for well-child care. However, when screened, they were more likely to endorse depression and suicide risk. This suggests disparities in depression screening and risk among autistic youth compared to non-autistic youth. Additional research should evaluate the source of these disparities, explore barriers to screening, and examine longitudinal outcomes of positive results among this population. WHAT'S NEW: We describe the current status of depression screening among autistic adolescents compared to their non-autistic peers in a primary care network with well-established universal electronic screening, and the demographic and clinical factors associated with screening completion and positivity in both groups.
Language: en |