Identifying depression among adolescents using three key questions: a validation study in primary care

Haugen, Wenche; Haavet, Ole Rikard; Sirpal, Manjit Kaur; Christensen, Kaj Sparle

doi:10.3399/bjgp16x683461

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…The small number of studies included in this review and its small statistical test power might explain the lack of statistical significance between the effects of the subgroups. Clinical interviews are the gold standard in diagnosis of depression in adolescents (Haugen et al, 2016). At the same time, the sensitivity of most self-rating scales aiming to identify depression among adolescents is not above 75% (Salle et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis

et al. 2020

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Background: A noticeable proportion of adolescents with depression do not respond to guideline recommended treatment options. This systematic review and meta-analysis investigated the effectiveness of physical activity interventions as an alternative or complementary treatment for adolescents (12-18 years) with depression. The characteristics of the physical activity treatment that were most effective in reducing symptoms in adolescents with depression and the impact of methodological shortcomings in the existing research were also examined. Methods: Medline, PsycINFO, SPORTDiscus, ProQuest, and CENTRAL were searched for eligible records. Effect size estimates were pooled based on the application of a random-effects model. Potential moderation by physical activity characteristics (i.e., intensity, type, context, and time frame) and methodological features (i.e., type of control group and diagnostic tool to identify depression at baseline) was investigated by means of subgroup analyses and meta-regressions. The certainty of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The primary outcome was the antidepressant effect of physical activity at postintervention measurement time point. As secondary outcomes, the sustainability of effects after the end of physical activity treatment and the acceptability of physical activity treatments were assessed. Overall, 10 studies were included in the qualitative synthesis and 9 studies involving 431 patients were included in the quantitative synthesis. Conclusions: This review suggests that physical activity is effective in treating depression in adolescents. Physical activity sessions should be at least moderately intense [rate of perceived exertion (RPE) between 11 and 13] to be effective. Furthermore, our results suggest that physical activity treatments are well accepted. However, the low methodological quality in included studies might have led to effect overestimation. Therefore, more studies with higher methodological quality are needed to confirm the recommendation for physical activity treatments in adolescents with depression.

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Section: Discussionmentioning

confidence: 99%

Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis

et al. 2020

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“…For example, patients with bipolar disorders, eating disorders, psychotic disorders, and dementia might be incorrectly identified as having a major depressive episode (Inoue et al 2012). The wording and order of questions of the PHQ-9 were adapted for a modified version for teens (PHQ-9M) (Aggarwal et al 2017), and additional efforts focused on streamlining of the assessments for primary care environments (Richardson et al 2010;Haugen et al 2016). The PHQ-9 and the modified version are now widely used for adolescents in primary care and child and adolescent psychiatry clinics but without a full understanding of their psychometric properties (Richardson et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of the Patient Health Questionnaire-9 Modified for Major Depressive Disorder in Adolescents

Nandakumar

Voort

Nakonezny

et al. 2019

Journal of Child and Adolescent Psychopharmacology

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Objectives: The Patient Health Questionnaire-9 Modified (PHQ-9M) is a self-report tool used to assess the presence and severity of depressive symptoms in teenagers. Despite widespread use in primary care clinics and psychiatric settings, the PHQ-9M has not been validated nor are its psychometric properties adequately understood for the adolescent population. This study sought to examine the psychometrics of the PHQ-9M in treatment-seeking, depressed adolescents at a psychiatric psychopharmacology clinic who were concurrently assessed with the Children's Depression Rating Scale Revised (CDRS-R) and Quick Inventory of Depressive Symptomatology-Adolescent (17-item) Self-Report (QIDS-A17-SR). Methods: Adolescents (N = 160) aged 13 through 18 years with a diagnosis of major depressive disorder, determined on the basis of a clinical interview and semi-structured interview using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, were assessed for severity of depressive symptoms with the PHQ-9M, CDRS-R (adolescent interview only), and QIDS-A17-SR assessments at baseline, 4, and 8 weeks. Classical test theory analysis was used to evaluate the internal consistency and dimensionality of the PHQ-9M. Convergent validity was evaluated via intraclass correlations of the PHQ-9M with the CDRS-R and QIDS-A17-SR. Sensitivity to treatment response was also evaluated. Results: The internal consistency (Cronbach's coefficient a) at baseline, 4, and 8 weeks was 0.879, 0.859, and 0.827 for the PHQ-9M; 0.739, 0.835, and 0.867 for CDRS-R; and 0.712, 0.777, and 0.804 for QIDS-A17-SR, respectively. The PHQ-9M had moderate convergent validity with the CDRS-R but good convergent validity with the QIDS-A17-SR. The PHQ-9M was less sensitive to changes in symptom severity than the CDRS-R and QIDS-A17-SR. Conclusions: The PHQ-9M appears to be a valid and reliable assessment tool for the severity of depressive symptoms in a psychiatric clinic setting. However, its utility as a treatment outcome measure may be limited compared with other available rating scales.

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“…This result may be related to the bias in the screening process of some subjects and the inclusion of some false positive samples. As we all know, clinical interview is the gold standard for the diagnosis of adolescent depression ( Haugen et al, 2016 ), while but the sensitivity of most self-rating scales for adolescent depression is less than 75% at present ( Salle et al, 2012 ). The difference in sensitivity between the two diagnostic methods means that a higher percentage of false positive samples will be screened out by the self-rating Depression Scale compared to structured clinical interviews.…”

Section: Discussionmentioning

confidence: 99%

The strategies of exercise intervention for adolescent depression: A meta-analysis of randomized controlled trials

Zhang

Liu²,

Chen³

et al. 2023

Front. Psychol.

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PurposeThis study aimed to investigate the effect of exercise intervention, and analyze exercise intervention strategies for adolescent depression through a meta-analysis of RCTs.MethodsAccordance to PRISMA guidelines, PubMed, Medline, EBSCO, Web of Science, SPORTDiscus, PsycINFO, ProQuest, and CNKI were searched for eligible records. Peer-reviewed studies were included if they met the following criteria: population (mean age of 10–18 years), intervention (physical activity, sport, or exercise), and outcomes (depression, adherence, ITT, dropout, adverse events, follow-up report). The protocol of this systematic review was registered in PROSPERO (CRD42022321683). Effect sizes calculations and methodological quality of exercise intervention (TESTEX scale) were carried out. The certainty of evidence was assessed by GRADE framework.ResultsThirteen randomized controlled trials were eligible for this review, which comprised a total of 433 adolescents. Compared with the control treatment, the effect of exercise on adolescent depression was moderate (SMD = −0.65, 95%CI: −1.03 to −0.27, p < 0.01). Heterogeneity was substantial (T2 = 0.30, I2 = 67%, p < 0.01). The moderating effect analysis showed that exercise intervention characteristics (organization form, exercise frequency, exercise intensity, exercise type, and single exercise session duration) of included studies varied greatly revealing multiple factors that may impact the antidepressant effect of exercise on adolescent depression (I2 > 50%, p < 0.05). Three studies show that the positive effect of exercise on reducing depression in adolescents remained 40 weeks after the intervention. Moreover, owing to the included studies contained methodological limitations, the certainty of evidence was reduced to moderate level.ConclusionThis study shows that exercise intervention has a moderate and sustained positive effect on adolescent depression. Our results recommended that adolescents with depression undertake moderate to high intensity group mixed exercise for more than 12 weeks, 20 to 60 min/time, more than 3 times/week. Additionally, our study also shows that the antidepressant effects remained for a long time after the end of exercise interventions. However, following the GRADE framework, we rated the certainty of evidence the primary meta-analysis as moderate evidence due to some limitations of included studies. Therefore, rigorous studies are still needed to verify the results.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321683], identifier [CRD42022321683].

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Identifying depression among adolescents using three key questions: a validation study in primary care

Abstract: Background

Cited by 6 publications

References 36 publications

Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis

Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis

Psychometric Properties of the Patient Health Questionnaire-9 Modified for Major Depressive Disorder in Adolescents

The strategies of exercise intervention for adolescent depression: A meta-analysis of randomized controlled trials

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