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Lit Review: A systematic literature review identified 16 studies supporting the use of standardized screening to enhance early detection of anxiety and depression in pediatric chronic pain populations. Methods: This evidence-based initiative was conducted at a pediatric pain management clinic within a teaching hospital, using the Johns Hopkins Evidence-Based Practice Model and the Plan-Do-Study-Act (PDSA) Model. The project aimed to improve early identification of chronic pain, anxiety, and depression by integrating screening tools: Generalized Anxiety Disorder–2 (GAD-2) for patients aged 8 and older and the Patient Health Questionnaire–2 (PHQ-2) for those aged 12 and older. In three months, 322 patients were screened, and those who scored 3 or higher underwent further evaluation using the GAD-7 and PHQ-9. The analysis focused on screening completion rates, symptom severity, comorbidity, and alignment with established cut-off points. PICO: In pediatric and adolescent patients with chronic pain (P), how does standardized mental health screening (I), compared to no standardized screening (C), affect early identification of anxiety and depression (O) over three months (T)? Results: Screening rates improved to 69.9% for anxiety and 60.4% for depression but remained below the 88% benchmark. The majority of participants were female (69.9%), with 28% identifying as Hispanic. A significant percentage reported mild to moderate anxiety and moderate to severe symptoms of depression. There was a 36.4% increase in dual-positive screenings, indicating improved detection. Statistical analysis showed a median GAD-2 score of 1 and a PHQ-2 score of 0, underscoring the need for targeted interventions.

Publication Date

11-9-2026

Keywords

Pediatric nursing

PEDIATRIC TRIAD - IMPROVING EARLY RECOGNITION OF COMORBID CHRONIC PAIN, ANXIETY, AND DEPRESSION

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