儿科初级保健心理整合项目用PHQ-9与GAD-7监测患者进展

ORIGINAL RESEARCH article

Front. Psychol.

Sec. Psychology for Clinical Settings

• 1. Rady Children's Hospital-San Diego, San Diego, United States

• 2. University of California San Diego, La Jolla, United States

Abstract

Introduction Measurement informed care (MIC) utilizes validated instruments to screen and monitor patient symptoms, shown to improve patient outcomes and streamline diagnostic processes. Our primary care mental health integration (PCMHI) program embedded mental health clinicians in the pediatric primary care setting to increase access to and provide care for adolescents. The purpose of this study was to identify changes in patient self-reported symptom severity and determine whether provider assessment of patient progress was associated with patient completed screening scores between the initial and final visits of short-term treatment for patients in a PCMHI program. Methods Patients were from a multisite pediatric PCMHI program. The program's standardized measures collected include the PHQ-9 and GAD-7 for patients > 12 years of age and the PSC-17 for patients <12 years. Prior to each PCMHI program sessions, patients complete self-reported assessments and, after the session, clinicians provide a score for overall patient progress. Patients treated Data were extracted from electronic medical records and changes in patient scores were calculated and analyzed using STATA 16.1 (College Station, TX). Results A total of 2,702 patients were eligible for analysis. Significant reductions (95% CI) in the proportion of patients scoring above clinically relevant cutoffs were observed for the PHQ-9 (28.8%; 26.1–31.5%), GAD-7 (25.8%; 23.4–28.4%), PSC-17 attention subscale (16.5%; 14.6–18.6%), and PSC-17 internalizing subscale (17.3%; 15.3–19.4%) (all p < 0.001). No significant change was identified for the PSC-17 externalizing subscale (11.0%; 9.4–12.8%; p = 0.19). Effect sizes for score change among patients above the clinical cutoff were large (r = 0.68–0.80 across PHQ-9 and GAD-7 severity scoring), and the odds of moving below the cutoff exceeded the odds of moving above it for every measure except the externalizing subscale. CGI improvement scores were significantly correlated with the PHQ-9, GAD-7, and each of the PSC-17 subscales (all p < 0.001). Conclusions Validated mental health assessments, completed by patients before their appointments, documented reductions in symptom severity over brief, short-term treatment, and change in patient-and clinician-completed assessments were significantly correlated. Results demonstrate the feasibility of using patient provided self-assessments to monitor patient progress.

Keywords

Measurement Informed Care, Mental Health, Pediatrics, primary care integration, screeners

Received

03 June 2026

Accepted

18 September 2026

Copyright

© 2026 Adams, Schweitzer, Holt, Bird, Carr-Lee and Hollenbach. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence:

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