Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Child and Adolescent Psychiatry, University of Lund, Lund, Sweden.
Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, RKBU Midt-Norge, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
PLoS One. 2020 Mar 25;15(3):e0230623. doi: 10.1371/journal.pone.0230623. eCollection 2020.
To evaluate screening efficiency and suggest cut-offs for parent and child Mood and Feelings Questionnaire (MFQ) and the short version (SMFQ) in unselected help seeking child- and adolescent psychiatric outpatients for subgroups of 6-12 versus 13-17 year olds and boys versus girls.
Eligible for inclusion were newly admitted outpatients age 6-17 years (n = 5908) in four Swedish child- and adolescent psychiatry clinics. They were prompted consecutively and n = 307 accepted a specific day for assessment until time slots randomly were filled. We prospectively validated the MFQ (33 items) and SMFQ (13 items) in patients (n = 186) using receiver operating characteristics against a reference test of Longitudinal Expert All Data DSM-IV depression based on a Kiddie-Schedule for Affective Disorders and Schizophrenia and 1.2 (sd .6) years of follow-up.
A depressive disorder was confirmed in 59 (31.7%) patients ranging from 14.0% for girls 6-12 years to 53.3% for girls 13-17 years. SMFQ performed roughly equivalent to MFQ. Adolescent score on SMFQ discriminated fairly for boys with Area Under Curve .77 (95% confidence interval .59-.81) and good (.82, .69-.91) for girls and parent ratings for adolescent girls (.85, .73-.93), but not for boys. Depression in children below age 13 could not be discriminated by MFQ or SMFQ whether filled in by child and mostly also when filled in by parent. Favouring maximum kappa value, the optimal cut-off was for MFQ self-report girls ≥32 versus boys ≥11 and for SMFQ self-report girls ≥17 versus boys ≥ 6. Suggested clinical SMFQ cut-offs for girls were ≥12 and for boys ≥ 6.
MFQ and SMFQ can, with gender-based cut-offs, be used for screening in clinical populations of adolescents but not in children. Parent MFQ and SMFQ can be used for adolescent girls but not boys. SMFQ is sufficient for screening.
为了评估筛选效率,并为未选择的寻求帮助的儿童和青少年精神病门诊患者中的 6-12 岁与 13-17 岁年龄组和男孩与女孩亚组的父母和儿童情绪和情感问卷(MFQ)和简短版(SMFQ)建议截断值。
符合纳入标准的是来自瑞典四家儿童和青少年精神病诊所的新入院年龄在 6-17 岁(n=5908)的门诊患者。他们连续被提示,n=307 名患者接受了特定的评估日期,直到随机时间安排已满。我们前瞻性地在 186 名患者中使用接收者操作特征(ROC)对 MFQ(33 项)和 SMFQ(13 项)进行了验证,参考测试是基于 Kiddie-Schedule for Affective Disorders and Schizophrenia 的纵向专家所有数据 DSM-IV 抑郁和 1.2(标准差为.6)年的随访。
59 名(31.7%)患者被确诊为抑郁症,其中女孩 6-12 岁的比例为 14.0%,女孩 13-17 岁的比例为 53.3%。SMFQ 的表现大致与 MFQ 相当。SMFQ 青少年得分对男孩的区分能力相当,曲线下面积为.77(95%置信区间.59-.81),对女孩为良好(.82,.69-.91),对青少年女孩的父母评分也是如此(.85,.73-.93),但对男孩则不然。MFQ 或 SMFQ 无法区分 13 岁以下儿童的抑郁,无论是儿童自评还是家长代评。最优截断值为 MFQ 自评女孩≥32 与男孩≥11,SMFQ 自评女孩≥17 与男孩≥6。建议的 SMFQ 临床截断值为女孩≥12,男孩≥6。
MFQ 和 SMFQ 可以根据性别设定的截断值用于青少年的临床人群筛查,但不能用于儿童。MFQ 和 SMFQ 父母可以用于青少年女孩,但不能用于男孩。SMFQ 足以进行筛查。