755 - Bridging the Gap: Discrepancies Between Caregiver Perceptions and Adolescent-Reported Mental Health

Publication Number: 755.4210

Tatiana Ndjatou, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, BROOKLYN, NY, United States; Ellen J. Silver, Albert Einstein College of Medicine, Newberg, OR, United States; Ruth EK. Stein, Albert Einstein College of Medicine, Larchmont, NY, United States; Suzette O. Oyeku, The Children's Hospital at Montefiore, Bronx, NY, United States; Jessica Rieder, The Children's Hospital at Montefiore, Bronx, NY, United States

Background: Depression and anxiety significantly impact adolescent mental health (MH) and development. Identification and treatment are crucial, yet caregivers often face challenges recognizing these symptoms. Adolescents may experience depressive and anxiety symptoms differently than caregivers perceive, complicating early detection and intervention. Studies suggest caregivers may underreport or misinterpret the severity of their children's MH issues potentially impacting the quality of care and support they receive.

Objective: To assess the association of caregiver-reported perceptions of depression and anxiety with adolescent self-reported severity of these conditions.

Design/Methods: Adolescents admitted to a children’s hospital in the Bronx, NY, completed the PHQ-9A and GAD-7, validated screening tools for depression and anxiety. Caregivers completed adapted questions from the National Survey of Children’s Health assessing their adolescent’s current depression and anxiety status. Chi-square tests evaluated the association between caregiver perceptions and adolescent-reported severity.

Results: 250 adolescent/caregiver dyads participated. Adolescent mean age was 15.05 (±1.42) years; 124 (50%) were female, 113 (45.2%) male, and 9 (3.6%) gender diverse; 117 (47%) Hispanic, 64 (26%) Black, 34 (14%) Mixed, and 20 (8%) White. Most caregivers 193 (77%) were mothers. Adolescents had a mean PHQ-9 score of 7.32 (±5.68), indicating mild depression, and a mean GAD-7 score of 6.00 (±5.25), indicating mild anxiety. PHQ-9A scores were higher in gender diverse vs cis female and male adolescents (13.22 vs 7.92, 5.94, p<.001) and GAD-7 scores were higher in gender diverse vs cis female and male adolescents (11.89 vs 6.8, 4.56, p<.001). There was no significant variation based on age or race/ethnicity. A significant association was found between caregiver perceptions and adolescent-reported severity of depression and anxiety, though discrepancies existed (Table 1). Most caregivers did not report depression in adolescents with moderate and moderately severe symptoms (68.8%, 60%). For anxiety, fewer discrepancies existed, yet 45% of caregivers did not report it in adolescents with moderate self-reported anxiety.

Conclusion(s): The study reveals a significant association between caregiver perceptions and adolescent self-reported depression and anxiety severity. However, it also highlights caregivers underreporting depression and anxiety in their adolescents. This emphasizes the importance of adolescent self-report and improved caregiver education of depressive and anxiety symptoms to support adolescents with MH challenges.

Associations Between Caregiver Perceptions and Adolescent-Reported Anxiety and Depression Severity