Orchard Faith, Pass Laura, Cocks Laura, Chessell Chloe, Reynolds Shirley
School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Child Adolesc Ment Health. 2019 Nov;24(4):338-344. doi: 10.1111/camh.12348. Epub 2019 Sep 28.
The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms.
In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents' (n = 46) and parents' (n = 46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1997, 980) and the Mood and Feelings Questionnaire (Journal of the American Academy of Child and Adolescent Psychiatry, 27, 1988, 726).
In the clinical interview, diagnostic criteria were more often met based on the adolescent's report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report.
These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression and have an established pathway to services that offer assessment and treatment. Key Practitioner Message Diagnosis of depression in adolescents requires the identification of specific symptoms and can be identified using interviews or questionnaires. Previous research has suggested that parents and young people provide differing reports regarding symptoms of adolescent depression. Results indicated that diagnostic criteria were more often met based on young person report and that parents reported significantly less symptoms. Parent-child agreement about specific symptoms was found to be low. Assessment of adolescent depression should not rely solely on parental report. Young people should be encouraged and enabled to recognise symptoms of depression and be able to access mental health services.
青少年抑郁症的诊断依赖于识别特定的核心症状和附加症状。症状可通过结构化或非结构化访谈以及一系列问卷测量来识别，这些问卷由青少年本人及其父母或照料者填写。本研究的目的是检验父母报告和青少年自我报告的抑郁症状的评分者间信度和评分者内信度。
在一个亲子二元组样本中，13至17岁的青少年因抑郁症被转介至心理健康服务机构，我们研究了青少年（n = 46）和父母（n = 46）对《学龄儿童情感障碍和精神分裂症量表》（《美国儿童与青少年精神病学会杂志》，36，1997，980）和《情绪与感受问卷》（《美国儿童与青少年精神病学会杂志》，27，1988，726）的独立回答。
在临床访谈中，基于青少年的报告更常符合诊断标准，且青少年认可的抑郁症状比其父母更多。初步结果还表明，亲子双方对特定症状的一致性较低。比较不同抑郁测量方法发现，青少年在问卷和访谈中的报告显著相关。然而，父母问卷和访谈报告之间没有显著相关性。
这些结果表明，仅依靠父母来识别孩子的抑郁症可能会导致抑郁症青少年被漏诊，进而得不到治疗。应鼓励并使青少年自身能够识别抑郁症状，并建立通往提供评估和治疗服务的途径。关键从业者信息 青少年抑郁症的诊断需要识别特定症状，可通过访谈或问卷来识别。先前的研究表明，父母和青少年对青少年抑郁症症状的报告存在差异。结果表明，基于青少年报告更常符合诊断标准且父母报告的症状明显更少。发现亲子双方对特定症状的一致性较低。青少年抑郁症的评估不应仅依赖父母报告。应鼓励并使青少年能够识别抑郁症状并获得心理健康服务。
