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

Area of Science:

• Adolescent psychiatry
• General practice research
• Diagnostic tool validation

Background:

• Adolescent depression is a significant mental health concern.
• General practitioners (GPs) are crucial for early identification of depression in adolescents.
• Validated screening tools for adolescent depression in general practice are limited.

Purpose of the Study:

• To assess the validity of three verbally administered key questions for identifying depression in adolescents.
• To evaluate the diagnostic accuracy of these questions in a primary care context.

Main Methods:

• A cross-sectional validation study involving 294 adolescents (aged 14-16) in Norway and Denmark.
• Adolescents answered three key screening questions, followed by the Composite International Diagnostic Interview (CIDI).
• Analysis included Receiver Operating Characteristic (ROC) curve statistics (sensitivity, specificity, predictive values) and reliability measures.

Main Results:

• The three key questions demonstrated construct and criterion validity for detecting adolescent depression.
• ROC analysis showed an Area Under the Curve (AUC) of 0.79 for 'yes' to either screening question and 0.73 for 'yes' to the help question.
• The negative predictive value was high at 97%, indicating strong ability to rule out depression.

Conclusions:

• The three verbally asked key questions are valuable tools for identifying depression in adolescents within primary healthcare settings.
• These questions offer a practical and valid approach for GPs to screen for adolescent depression.