203 - Impact of COVID-19 on Depression Symptoms in Adolescents

Poster Number: 203
Publication Number: 203.400

Melissa S. Van Cain, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Annamaria Malati, University of Oklahoma College of Medicine, Tulsa, OK, United States; Amy D. Hendrix-Dicken, University of Oklahoma Health Sciences Center, Tulsa, OK, United States; Michelle Condren, University of Oklahoma College of Medicine, Tulsa, OK, United States; Kristine K. Myers, University of Oklahoma College of Medicine, Tulsa, OK, United States; Juell Homco, University of Oklahoma, Tulsa, OK, United States

Background: The COVID-19 pandemic has significantly altered life in the US. Public health policies implemented to mitigate transmission of the disease, such as school closures and social distancing, have had wide-ranging effects on the wellbeing of individuals.

Objective: To examine whether depressions symptoms, as measured by the PHQ-9, increased in the adolescent and young adult populations during the COVID-19 pandemic.

Design/Methods: Demographic and PHQ-9 data from was extracted from the electronic medical record (EMR) for individuals 11-25 years old who were seen at OU Health Tulsa Pediatric clinics June 1, 2019—March 31, 2021. For analysis purposes the data was grouped into two time periods: “Pre COVID restrictions” (June 1, 2019-March 31, 2020) and “Post COVID restrictions” (June 1, 2020-March 31, 2021). Visits from April and May 2020 were not included in the analysis due to clinic restrictions which limited visits. The analysis examined individuals who had PHQ-9 scores in both pre and post periods. If an individual had more than one score in a time period, scores were averaged to create a mean score for that period. Each individual’s pre-score was then subtracted from their post-score and a Wilcoxon signed rank test was used to determine whether there was a significant difference between scores after controlling for demographic differences. Data was also analyzed looking at proportion of visits of differing depression symptom severity (mild 0-4, moderate 5-14, severe >15) between time periods using Chi Square Symmetry test.

Results: There were 1660 PHQ-9s completed in the pre period and 1697 PHQ-9s completed in the post period. Of these, 982 patients completed responses in both time periods. Figure 1 shows the average PHQ-9 scores per month for the pre and post periods. The average score was 4.93 (SD 0.38) for the pre period and 5.08 (SD 0.40) for the post with a p-value of 0.64. The median difference between pre and post periods was zero with a p-value of 0.54. Table 1 shows the basic demographic data of patients with PHQ-9 scores in both time periods. Table 2 compares the severity of depression symptoms in the pre and post periods using chi square symmetry test with a p-value of 0.08. Conclusion(s): We found no significant difference in the PHQ-9 scores between pre and post COVID time periods. While the average score by month increased over time for both time periods, we posit that this is likely due to the seasonality of depression. A longer period of assessment and clinical diagnoses of depression and suicidality should be considered in future research.
Figure 1. Average PHQ-9 Score by Month in Pre and Post COVID Time Periods
Table 1. Demographic Data of Patients with PHQ-9 Scores in Both the Pre and Post Time PeriodsDemographic data of the 982 patients with PHQ-9 scores in both time periods shows a population with a mean age of 14.97. A majority of patients identified as White (72.71%), Hispanic (50.51%), and female (52.95%). The most commonly identified preferred language was English (35.95%), but many were missing data (null 28.41%).