Adolescent depression beyond DSM definition: a network analysis

Area of Science:

• Psychiatry
• Adolescent Psychology
• Mental Health Research

Background:

• Growing calls to understand depression beyond diagnostic criteria.
• Adolescent depression requires nuanced understanding beyond existing frameworks.
• Previous research often focuses narrowly on DSM-defined symptoms.

Purpose of the Study:

• To examine the prevalence and relevance of DSM and non-DSM depressive symptoms in Brazilian adolescents.
• To analyze the network structure and centrality of depressive symptoms using two common scales.
• To compare the centrality of DSM-included versus non-DSM symptoms in adolescent depression.

Main Methods:

• Cross-sectional analysis of two school-based adolescent samples (N=7720 and N=1070) aged 14-16.
• Utilized the Patient Health Questionnaire (PHQ-A) and Mood and Feelings Questionnaire (MFQ) for symptom assessment.
• Employed network analyses to investigate symptom structure and centrality.

Main Results:

• In the PHQ-A sample, sad mood and worthlessness were most central.
• In the MFQ sample, non-DSM symptoms (self-hatred, loneliness) were most central.
• DSM and non-DSM symptoms formed a highly interconnected network, with non-DSM items often being more central.

Conclusions:

• Depressive symptom networks in adolescents are complex and include significant non-DSM features.
• Focusing on a broader range of symptoms, including non-DSM ones, is crucial for advancing adolescent depression research.
• DSM criteria may not fully capture the interconnectedness and centrality of symptoms experienced by adolescents.