青少年抑郁与自杀行为：一种多信息源和多方法的诊断分类研究。
Depression and suicidal behavior in adolescents: a multi-informant and multi-methods approach to diagnostic classification.
机构信息
School of Psychology, Deakin University Melbourne, VIC, Australia.
Eastern Health Clinical School, Turning Point, Monash University Melbourne, VIC, Australia.
出版信息
Front Psychol. 2014 Jul 17;5:766. doi: 10.3389/fpsyg.2014.00766. eCollection 2014.
BACKGROUND
Informant discrepancies have been reported between parent and adolescent measures of depressive disorders and suicidality. We aimed to examine the concordance between adolescent and parent ratings of depressive disorder using both clinical interview and questionnaire measures and assess multi-informant and multi-method approaches to classification.
METHOD
Within the context of assessment of eligibility for a randomized clinical trial, 50 parent-adolescent pairs (mean age of adolescents = 15.0 years) were interviewed separately with a structured diagnostic interview for depression, the KID-SCID. Adolescent self-report and parent-report versions of the Strengths and Difficulties Questionnaire, the Short Mood and Feelings Questionnaire and the Depressive Experiences Questionnaire were also administered. We examined the diagnostic concordance rates of the parent vs. adolescent structured interview methods and the prediction of adolescent diagnosis via questionnaire methods.
RESULTS
Parent proxy reporting of adolescent depression and suicidal thoughts and behavior is not strongly concordant with adolescent report. Adolescent self-reported symptoms on depression scales provide a more accurate report of diagnosable adolescent depression than parent proxy reports of adolescent depressive symptoms. Adolescent self-report measures can be combined to improve the accuracy of classification. Parents tend to over report their adolescent's depressive symptoms while under reporting their suicidal thoughts and behavior.
CONCLUSION
Parent proxy report is clearly less reliable than the adolescent's own report of their symptoms and subjective experiences, and could be considered inaccurate for research purposes. While parent report would still be sought clinically where an adolescent refuses to provide information, our findings suggest that parent reporting of adolescent suicidality should be interpreted with caution.
背景
已有研究报告称，父母和青少年对抑郁障碍和自杀意念的评估存在信息差异。本研究旨在使用临床访谈和问卷调查评估青少年和父母对抑郁障碍的评估结果是否一致，并评估多信息源和多方法在分类中的应用。
方法
在评估随机临床试验入选资格的过程中，对 50 对青少年及其父母（青少年平均年龄为 15.0 岁）进行了单独访谈，使用抑郁的结构化诊断访谈（KID-SCID）进行访谈。还对青少年自评和父母报告的长处和困难问卷（SDQ）、短情绪和感觉问卷（SMFQ）和抑郁体验问卷（DEQ）进行了评估。我们考察了父母与青少年结构化访谈方法的诊断一致性，以及问卷方法对青少年诊断的预测情况。
结果
父母对青少年抑郁和自杀意念及行为的报告与青少年的报告并不完全一致。青少年在抑郁量表上的自评症状比父母对青少年抑郁症状的报告更能准确反映可诊断的青少年抑郁。青少年的自我报告测量可以结合起来以提高分类的准确性。父母往往会夸大其青少年的抑郁症状，而低估其自杀意念和行为。
结论
父母的代理报告明显不如青少年自己报告其症状和主观体验可靠，在研究目的方面可以认为不准确。虽然在青少年拒绝提供信息的情况下临床仍会寻求父母报告，但我们的研究结果表明，应谨慎解读父母对青少年自杀意念的报告。
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