Increases in Adolescent Mental Health Disorders and Antidepressant Prescriptions following the COVID-19 pandemic at HSC Clinics in Fort Worth, Texas

dc.creatorMorse, Elizabethen_US
dc.creatorMatches, Sarahen_US
dc.description.abstractPurpose: The COVID-19 pandemic exposed adolescents to unpredictable events including quarantines, school closures, and loss of loved ones, bringing a sense of fear, anxiety, and social isolation. This led to short-term and long-term mental health effects for adolescents. Most literature conducted throughout the pandemic showed an increase in depressive and anxiety symptoms in the adolescent population world-wide. This research aims to determine if these trends are seen in the specific population in Fort Worth, Texas at HSC clinics. Methods: Patient data from HSC Pediatrics and HSC Pediatric Mobile Clinic from 2019-2022 for ages 12-18 years old was pulled from EMR, NextGen, into Excel (n=18,359). Only the patient’s first visit each year was included (n=6,285). The data set was filtered into 3 categories: Depression, Anxiety, and Depression and Anxiety. The first visit each year for every patient who completed the PHQ-9 was included using the qualitative “Detail” data (n=3,479). A separate data set for the same patients on Antidepressant medications was used. Using Excel’s tools, totals and percentages were calculated for number of patients seen, ages, gender, race, ethnicity, PHQ-9, and medications. Results: Overall, the percentage of patient’s seen for all 3 categories increased from 2019 to 2022 despite less patients being seen since 2019. The greatest increase was seen in Depression from 2020 (10.71%) to 2021 (17.71%) from 2019 (4.93%). Patients with anxiety increased each year from 2019 (3.10%) to 2022 (11.98%). Over less than a half of patients completed the PHQ-9 from 2019 (990) to 2020 (455), however the percentage of patients who scored “Moderately Severe Depression” and “Severe Depression” increased from 2019-2020. The greatest increase was seen in “Mild Depression” from 2020 (24.84%) to 2021 (30.68%). Those who scored “None” decreased each year with 10.46% decrease from 2019 to 2022. Only “Moderately Severe Depression” increased each year. The number of patients prescribed antidepressant medications increased each year from 2019 to 2022 with the largest increase seen in those prescribed Escitalopram/Lexapro. Conclusion: The increase in Depression and Anxiety and antidepressant prescriptions in the adolescent population poses new challenges for providers, clinics, in-patient psych facilities, and families. To increase access to care and prevent no-show visits, telehealth visits can be implemented. Given the rise in mental health disorders in the adolescent population, training in Pediatric mental health and resources like Child Psychiatry Access Network (CPAN) should be more readily available. For each category, fewer patients were seen in 2020, possibly due to social distancing, fear of contracting COVID-19, and/or decreased clinic availability. Another limitation could be a lack of reporting due to parent vs. child reporting, lack of awareness, family values, and/or societal pressures. To prevent missed diagnoses or symptoms, more proactive screening is necessary. Additionally, approximately 1,000 fewer patients were seen in 2022 than 2019. Continued research into the long-term mental health effects from the pandemic is necessary to determine how to treat this generation now and in the future, as well as what certain subpopulations are more susceptible to not seek care or follow-up.en_US
dc.titleIncreases in Adolescent Mental Health Disorders and Antidepressant Prescriptions following the COVID-19 pandemic at HSC Clinics in Fort Worth, Texasen_US