Abstract
Background: Chronic pain and mental health disorders share a bidirectional relationship, with chronic pain increasing psychological distress and preexisting mental health conditions elevating pain risk. In pediatric populations, chronic pain carries a substantial economic burden in the U.S. (≈$19.5 billion annually) and is associated with persistent pain, psychiatric comorbidity, substance use, and reduced quality of life into adulthood.
Practice Question: Pediatric patients with chronic pain frequently have unrecognized anxiety and depression, and consistent mental health screening is lacking.
PICOT: 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)?
Evidence: A systematic literature review identified 16 studies supporting standardized screening to improve early detection of anxiety and depression in pediatric chronic pain populations.
Methods: Over three months (June–August 2025), data were collected from 322 pediatric chronic pain patients at a teaching hospital pain clinic. Screening rates and results using GAD-2 and PHQ-2 were evaluated alongside longer-form measures. Exploratory analyses informed cutoff validation using diagnostic data (n=11).
Results: Screening implementation increased to 69.9% for GAD-2 and 60.4% for PHQ-2 (mean 65.15%), representing a meaningful improvement despite not reaching the 88% benchmark. Dual-positive anxiety and depression screening increased by 36.4%.
Conclusion: The GAD-2 and PHQ-2 demonstrated acceptable psychometric performance and practical utility in this population, supporting their continued use for early identification of anxiety and depression in pediatric chronic pain care.
Date of publication
Spring 2026
Document Type
DNP Scholarly Project
Language
english
Persistent identifier
http://hdl.handle.net/10950/5050
Committee members
Mary McInnis DNP, Deanna Adams, DNP, Emily Fox DNP, Jennifer Chilton, PhD
Degree
Doctor of Nursing Practice
Recommended Citation
Kiarie, Judy W., "DNP Final Report: PEDIATRIC TRIAD: EARLY RECOGNITION OF COMORBID CHRONIC PAIN, DEPRESSION, AND ANXIETY IN PEDIATRICS" (2026). DNP Final Reports. Paper 84.
http://hdl.handle.net/10950/5050
Included in
Behavioral Medicine Commons, Family Medicine Commons, Family Practice Nursing Commons, Mental Disorders Commons, Pediatric Nursing Commons, Pediatrics Commons, Primary Care Commons, Psychiatric and Mental Health Nursing Commons, Psychiatry Commons