712 - Impacts of the Coronavirus disease (COVID-19) pandemic on depression in teens

Pediatric depression is an exigent public health concern, especially in the wake of the Coronavirus disease (COVID-19) pandemic. Globally, the prevalence of anxiety and depression has doubled compared with pre-pandemic estimates.

Objective: The aim of this research study is to further characterize the association between the COVID-19 pandemic and pediatric depression by analyzing the Patient Health Questionnaire (PHQ-9) scores obtained in the outpatient setting.

Design/Methods: A retrospective chart review of electronic health records was conducted using a clinical database of outpatient pediatric clinics. The sampling frame included patients aged 12-18 who had a clinic visit March-December 2019 and/or January-December 2021. Changes in depression screening (PHQ-9 scores) were analyzed using generalized linear mixed models.

Results:

Depression screening increased after the onset of COVID-19 by 63.4%. The percentage of adolescents screening positive for depressive symptoms before and during the pandemic was 19.81% and 29.75%, respectively, n=1,938. CovidTimes (pre-pandemic vs. mid-pandemic), sex, and age were significant predictors of depression type (mild, moderate, moderately severe, and severe), p < .001, relative to the reference depression category (none/minimal). Mid-pandemic PHQ-9 scores were significantly higher than pre-pandemic scores for individuals indicating moderate (OR = 0.608, 95% CI [-0.815, -0.181]) and moderately severe depression (OR = 0.633, 95% CI [-0.876, -0.037]) when compared with minimal depression. For all levels of depression, females were more likely to indicate statistically significant higher PHQ-9 scores than males, mild depression (OR = 1.362, 95% CI [0.074, 0.544]), moderate depression (OR = 2.631, 95% CI [0.667,1.268]), moderately severe depression, (OR = 3.321, 95% CI [0.800, 1.160]), and severe depression (OR = 7.358, 95% [1.371, 2.620]. Older teenagers were significantly more likely to indicate higher PHQ-9 scores than younger teens across all depression categories, mild (OR = 1.103, 95% CI [0.037, 0.160]), moderate (OR = 1.174, 95% CI [0.087, 0.234]), moderately severe (OR = 1.254, 95% CI [0.133, 0.319]), and severe (OR = 1.281, 95% CI [0.116, 0.380]).

Conclusion(s): The results of this study demonstrate a significant increase in PHQ-9 scores in adolescents after the onset of the COVID-19 pandemic, especially in females, older teenagers, and individuals with a prior history of depressive symptoms. These results support an urgent need for increased mental health resources in the pediatric population, with targeted intervention for these demographics.