168 - Changes in Depression Scores in Large Pediatric Ambulatory Network During the COVID-19 Pandemic

Poster Number: 168
Publication Number: 168.316

Shira Y. Kaye, Cohen Children's Medical Center, Flushing, NY, United States; Caren Steinway, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States; Jack Chen, Northwell Health, Jamaica, NY, United States; Sophia Jan, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: Children are particularly vulnerable to the physical, social, and emotional uncertainties of the COVID-19 pandemic. While numerous studies during the pandemic have analyzed changes in pediatric mental health during this time, many have been conducted outside the United States, are primarily narrative reviews, are patient-reported surveys, or are cross-sectional analyses. To date, there have been few studies utilizing routine depression screening, documented in the electronic health record (EHR), to assess longitudinal changes in depression rates from before to during the pandemic. 

Objective: To assess if rates of adolescent depressive symptoms have increased during the COVID-19 pandemic, and whether these changes can be seen through routine depression screening during outpatient pediatric visits in a large regional pediatric ambulatory network. 

Design/Methods: A retrospective longitudinal cohort study was conducted using data from a population health registry at a large clinically integrated health system. Eligible participants (Nf1,372) included patients with PHQ-2 or PHQ-9 depression scores seen in both 2019 (pre-COVID) and 2020 or 2021 (COVID era) between the ages of 10-20. Additionally, patient demographics (age, sex, race/ethnicity, insurance status, and BMI index) were extracted. To understand how depressive symptoms have changed over time, individual depression scores were compared pre and during COVID.  

Results: Patients were mostly female (54%), over the age of 14 (52%), White (51%), non-Hispanic/Latino (51%), and had private insurance (67%). Overall, patients had an average increase of 0.48 in PHQ scores in the COVID era when compared to their pre-COVID PHQ score (P  .001), indicating worsening depression. Changes by subpopulation are described in Table 1. Conclusion(s): This study shows that there has been a statistically significant rise in depressive symptoms among adolescents in a large regional ambulatory network from before COVID-19 throughout the COVID-19 pandemic. This is consistent with earlier studies demonstrating a rise in adolescent mental health problems since COVID-19, but also illustrates that individual changes in mental health can be seen in routine adolescent depression screening. These results highlight the importance of proper screening in outpatient pediatric visits.  
Table 1Mean change in PHQ scores over time among adolescents seen across a clinically integrated health network from 2019-2021