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Assessing a prediction model for depression risk using an early adolescent sample with self-reported depression.
Eileen Y Xu1, Niamh MacSweeney1, Gladi Thng1
1Division of Psychiatry University of Edinburgh Royal Edinburgh Hospital Edinburgh UK.
JCPP Advances
|June 16, 2025
Summary
The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) can predict major depressive disorder (MDD) in younger adolescents. Refitting the model improves accuracy, highlighting family conflict and caregiver relationship as key risk factors for early-onset depression.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Research
- Predictive Modeling in Healthcare
Background:
- Major depressive disorder (MDD) in adolescence predicts adverse adult outcomes, with earlier onset linked to poorer prognosis.
- The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) predicts MDD in older youth (>15 years) but lacks validation in younger populations (<15 years).
- This study evaluated IDEA-RS applicability and predictive performance in early adolescents (9-11 years).
Purpose of the Study:
- To assess the generalizability of the IDEA-RS model to predict major depressive disorder (MDD) in early adolescents (9-11 years).
- To evaluate the accuracy and calibration of IDEA-RS predictions in a younger cohort.
- To identify key predictors of early-onset depression in this age group.
Main Methods:
- Applied existing IDEA-RS predictor weights to 9854 adolescents (9-11 years) from the ABCD Study.
- Derived incident depression outcomes (MDD and depression symptoms) from self-reported data at 2-year follow-up.
- Assessed prediction accuracy and calibration, comparing external replication with a refitted model using ABCD data.
Main Results:
- External replication showed better-than-chance prediction for incident MDD (AUC=61.4%) and depression symptoms (AUC=57.9%), but with poor calibration.
- Re-estimating predictor weights significantly improved discriminative capacity (MDD AUC=75.9%, DS AUC=64.8%) and calibration.
- Poorest caregiver relationship (OR=4.25) and high family conflict (ORs=3.36-3.76) were strongly associated with incident MDD.
Conclusions:
- IDEA-RS provides better-than-chance prediction in early adolescents, with improved accuracy after refitting to account for sample differences.
- The model is generalizable to younger populations when adjusted, suggesting its utility in research settings with adequate data.
- Family dysfunction, including caregiver relationship quality and conflict, significantly impacts early-onset depression.
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