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Content agreement of depressive symptomatology in children and adolescents: a review of eighteen self-report questionnaires

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Abstract

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale’s target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management.

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Funding

The following grants supported this work: Carlos III Health Institute (ISCII) FEDER (PI16/00165), and DIUE Commissioner for Universities and Research of the Generalitat de Catalunya (2017 SGR 452).

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Authors and Affiliations

  1. Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain

    Ana Vilar

  2. Institut de Neuropsiquiatria I Addiccions (INAD), Hospital de Dia Infanto Juvenil Litoral Mar, Parc de Salut Mar, Barcelona, Spain

    Ana Vilar

  3. Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain

    Néstor Sánchez-Martínez, Samantha Álvarez-Salazar & Carlos G. Forero

  4. CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain

    Maria Jesús Blasco

  5. Health Services Research Group, IMIM- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain

    Maria Jesús Blasco

  6. Institut de Neuropsiquiatria I Addiccions (INAD), Direcció Procés Atenció Comunitària I Programes Especials. Parc de Salut Mar, Barcelona, Spain

    Santiago Batlle Vila

  7. Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain

    Santiago Batlle Vila

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  1. Ana Vilar
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  2. Néstor Sánchez-Martínez
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Correspondence to Carlos G. Forero.

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Vilar, A., Sánchez-Martínez, N., Blasco, M.J. et al. Content agreement of depressive symptomatology in children and adolescents: a review of eighteen self-report questionnaires. Eur Child Adolesc Psychiatry (2022). https://doi.org/10.1007/s00787-022-02056-w

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