Sørensen Christine Leonhard Birk, Grønborg Therese Koops, Biering Karin
Department of Occupational and Environmental Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, 7400, Denmark.
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
BMC Pediatr. 2025 Mar 17;25(1):201. doi: 10.1186/s12887-025-05510-1.
Short efficient questionnaires to detect depressive symptoms in adolescents are sparsely evaluated. We aimed to examine the test-retest reliability and structural and convergent validity of the Danish version of the 6-item version of the Hopkins Symptom Checklist-core depression (SCL-6) in adolescents.
Our study population consisted of 122 adolescents. Ninety-one adolescents completed SCL-6 (test sample) in the first round, 82 adolescents completed SCL-6 in the second round (retest sample), with 66 completing the questionnaire both rounds (test-retest sample). Reliability was evaluated by intraclass correlation (ICC) and standard error of measurement (SEM), and structural validity was evaluated by confirmatory factor analysis (CFA) and Mokken analyses. Convergent validity was assessed using the 4-item version of the Centre for Epidemiological Studies Depression Scale (CES-DC4).
The mean sum score in the test sample was higher than in the retest sample (0.74 (95% CI:0.06;1.43)). The limits of agreement (LoA) were broad (-4.73;6.21). The intraclass correlation (ICC(1,1)) was 0.79 (95% CI:0.67;0.87)) showed good reliability, while the SEM (2.03 (95% CI: 1.68; 2.37)) was large considering the range of the scale. Cronbach's alpha showed good internal consistency at both test (0.80) and retest (0.81). The inter-item correlations and Mokken analyses supported the conclusion of a unidimensional scale. The CFA did not find an acceptable fit of a one factor solution. The convergent validity showed a moderate correlation with the CES-DC4 (0.48).
SCL-6 showed acceptable internal consistency and test-retest reliability. The results from the CFA were inconclusive in terms of demonstrating unidimensionality, but Mokken analyses supported unidimensionality like previous studies. We find the scale usable for population-based research on depressive symptoms in adolescents, but do not recommend it as screening tool on individual level.
用于检测青少年抑郁症状的简短有效问卷很少得到评估。我们旨在检验丹麦版6项霍普金斯症状清单核心抑郁量表（SCL - 6）在青少年中的重测信度、结构效度和收敛效度。
我们的研究人群包括122名青少年。91名青少年在第一轮完成了SCL - 6（测试样本），82名青少年在第二轮完成了SCL - 6（重测样本），其中66名在两轮中都完成了问卷（重测样本）。通过组内相关系数（ICC）和测量标准误（SEM）评估信度，通过验证性因子分析（CFA）和莫肯分析评估结构效度。使用4项流行病学研究中心抑郁量表（CES - DC4）评估收敛效度。
测试样本的平均总分高于重测样本（0.74（95%可信区间：0.06；1.43））。一致性界限（LoA）较宽（-4.73；6.21）。组内相关系数（ICC(1,1)）为0.79（95%可信区间：0.67；0.87），显示出良好的信度，而考虑到量表范围，测量标准误（2.03（95%可信区间：1.68；2.37））较大。克朗巴哈系数在测试（0.80）和重测（0.81）时均显示出良好的内部一致性。项目间相关性和莫肯分析支持单维度量表的结论。验证性因子分析未发现单因素解决方案的可接受拟合。收敛效度显示与CES - DC4有中度相关性（0.48）。
SCL - 6显示出可接受的内部一致性和重测信度。验证性因子分析的结果在证明单维度性方面尚无定论，但莫肯分析如先前研究一样支持单维度性。我们发现该量表可用于基于人群的青少年抑郁症状研究，但不建议将其作为个体层面的筛查工具。
