Q 36 or Q 37=Y ◆

TS ≥ 30

Administering, Scoring and Interpreting the PHQ-9 Screening Questionnaire

Administering

• The youth self-report version of the Pediatric Symptom Checklist (PSC-Y) can be used with patients between the ages of 11 and 18 and takes less than five minutes to complete and score.
• The PSC-Y can be administered and scored by a nurse, medical technician, physical assistant, physician or other office staff.
• Patients should be left alone to complete the PSC-Y in a private area, such as an exam room or private area of the waiting room.
• Patients should be informed of their confidentiality rights before the PSC-Y is administered.
• It is recommended that parents are informed that a mental health checkup will be administered as part of the exam.
• The American Academy of Pediatrics and U.S. Preventive Service Task Force recommend that depression screening be conducted annually.

Scoring

• Each item on the PSC-Y is scored as follows:
  • Never = 0
  • Sometimes = 1
  • Often = 2
• To calculate the score, add all of the item scores together:
  • Total Score = _______ (range 0-70)
  • If items are left blank, they are scored as 0.
  • If four or more items are left blank, the questionnaire is considered invalid.
  • note if either suicide question has been endorsed (Question 36 and 37).
• Score is positive if: Total Score >/=30
  OR
  Recent suicidal ideation is reported (Q36)
  OR
  Past suicide attempt is reported(Q37)

Interpreting the Screening Results

• Patients that score positively on their PSC-Y, it is recommended that the PCP briefly review the symptoms marked as "sometimes" and "often" with the patient.
• The Questionnaire indicates only the likelihood that a youth is at risk for a significant mental health problem or suicide; its results are not a diagnosis or a substitute for a clinical evaluation

The symbols on the questionaire and below represent the different problem areas that are covered on the PSC-Y and lists out the items that correspon with problem area.  Though this does not affect the overall score, the purpose of this breakdown is to help guide the discussion with and evaluation of patients after screening and allows the PCP to focus on the main problem areas identified by the PSC-Y.

Individual problem areas (For Interpretation Only)

▲ Internalizing problems (i.e. Depression or Anxiety)	● Attention Problems (i.e. ADHD)	■ Externalizing Problems (e.g. Conduct Disorder, Oppositional Defiant Disorder)	◆ Suicidality (if either question is endorsed, further assess for suicidal thinking and behavior and depression)
Feel Sad, unhappy Worry a lot Feel hopeless Seem to be having less fun Down on yourself	Fidgety, unable to sit still Distract easily Act as if driven by motor Daydream too much have trouble concentrating	Fight with other children Tease others Do not listen to rules Do not understand other people's feelings Blame others for your troubles Take things that do not belong to you	Recent suicide ideation Prior Suicide Attempt
Non-Categorizing Items
Complain of aches or pains Spend more time alone Tire easily, little energy Do not show feelings Have trouble with teacher	Less interested at school Are afraid of new situations Are irritable, angry Less interested in friends Absent from school	School grades dropping Visit doctor with doctor finding nothing wrong Have trouble sleeping Feel that you are bad	Want to be with parent more than before Take unnecessary risks Get hurt frequently Act younger than children your age