Development of a Depression Screening Protocol for At Risk Patients Based on the Adverse Childhood Experience Questionnaire

Background: Adverse childhood experiences (ACEs) are associated with increased risk for adult depression. Utilization of the Patient Health Questionnaire Nine (PHQ-9), in combination with Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSMV) criteria, aids in the diagnosis of comorbid depression and assessment of severity. Objectives: To standardize the process of screening new adult patients at a specialty care clinic for ACEs. Then, implement a depression screening protocol based on ACE criteria to identify adult patients with comorbid depression. Methods: Demographic, ACE score, PHQ-9 score, and protocol implementation data collected and analyzed by the Doctor of Nursing Practice (DNP) student during initial new patient visit, as well as subsequent visits (if applicable). Results: Of the 105 patients, 104 (99%) were appropriately screened for ACEs, and if applicable depression via the PHQ-9. Following protocol implementation, 15 patients were identified and diagnosed with comorbid depression with appropriate follow-up completed in 93%. Conclusions: Depression screening in at risk patients demonstrating significant childhood trauma leads to an increase in diagnosis comorbid depression. Implications: Depression screening in adults, following assessment of childhood trauma via the ACE questionnaire, aids in the identification of patients with comorbid depression