Adolescent Depression and Suicide Risk Screening

Many adolescents may not present with classic adult symptoms of depression. Pervasive boredom or irritability still may be symptoms of depression in this age group, as can self-injuring behaviors. It is important to ask them directly about past and current suicidal thoughts and attempts when there is any concern about depression or other mental health problems at every health supervision visit. The following are commonly used adolescent depression screening tools:

• Patient Health Questionnaire (PHQ-2*; PHQ-9; PHQ-A)
• Beck Depression Inventory (BDI)
• For information regarding mental health screening, see: https://downloads.aap.org/AAP/PDF/Mental_Health_Tools_for_Pediatrics.pdf
  *Does not include suicide risk question

Screening for depression alone is not sufficient to identify suicide risk. In practice, consider adding the Ask Suicide-Screening Questions (ASQ) to simultaneously screen for both depression and suicide risk for all patients at health supervision visits beginning at age 12.

The following are commonly used suicide risk screening tools:

• Ask Suicide-Screening Questions (ASQ)
• Columbia-Suicide Severity Rating Scale (C-SSRS)

Also see the AAP Blueprint for Youth Suicide Prevention (https://www.aap.org/en/patient-care/blueprint-for-youth-suicide-prevention).