Mental Health Screening in Pediatric Rheumatology: A Feasibility Study
Bibliographic record
Abstract
Objectives The aims of this study were: (1) to determine the acceptability and practicality of mental health screening in patients with juvenile idiopathic arthritis (JIA) during routine visits at a pediatric hospital multidisciplinary clinic; (2) to understand the frequency and severity of anxiety and depressive symptoms within this sample. Methods Patients with JIA aged 8-17 were invited to participate during their routine clinic appointments. Recruited participants completed 3 questionnaires on an iPad: PROMIS Pediatric Anxiety (v3), PROMIS Pediatric Depression (v3), and a short questionnaire regarding the acceptability of the screening process. Caregivers then completed a short questionnaire regarding the acceptability of the process. Our occupational therapist provided participants with feedback on their PROMIS scoring profile and relevant mental health resources during their clinic visit. Results Forty patient-parent dyads were recruited during routine follow-up appointments at the Rheumatology Clinic at BC Children’s Hospital between April and August 2024 (mean patient age = 13.5 years; 23 females). Another 26 families were approached but declined, primarily due to time constraints. The mean PROMIS Anxiety t-score was 51.79 (SD=11.06) and the mean PROMIS Depression t-score was 50.54 (SD=7.62), both similar to the general population (mean=50 SD=10). Six patients (15%) had elevated or very elevated anxiety scores, and 2 patients (5%) had elevated depression scores. Overall, 92% of patients and 95% of caregivers reported the screening process to be ‘Acceptable’ or ‘Completely Acceptable’, while 57% of patients and 87.5% of caregivers reported that the rheumatology team should check in about mental health. Most patients (87.5%) reported it took ‘No effort at all’ or ‘A little effort’ to complete the questionnaires. Ninety percent of caregivers reported they were ‘Very Comfortable’ or ‘Comfortable’ with their child completing the questionnaires. Patient and parent responses regarding the ideal frequency of the screening were evenly split between every visit, every 6 months and every year. Conclusion There was high acceptability of the mental health screening process among patients and caregivers. A greater percentage of caregivers compared to patients thought that the rheumatology team should check in about mental health during routine clinical visits. Most patients considered it took little additional effort to complete the questionnaires. The mean anxiety and depression scores were similar to the general population with a small proportion reporting elevated scores. Mental health screening is feasible within routine rheumatology clinic visits and should be considered by health professionals providing care for youth with JIA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".