Piccin Jader, Buchweitz Claudia, Manfro Pedro H, Pereira Rivka Barros, Rohrsetzer Fernanda, Souza Laila, Viduani Anna, Caye Arthur, Kohrt Brandon A, Mondelli Valeria, Swartz Johnna R, Fisher Helen L, Kieling Christian
Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
BMJ Ment Health. 2025 Apr 12;28(1):e301207. doi: 10.1136/bmjment-2024-301207.
Adolescence constitutes a critical window for preventing depression, but efforts have mostly targeted single risk factors. The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) integrates easily obtainable sociodemographic variables and has been able to predict future depression across diverse populations. However, its performance within a prospective cohort remains untested.
To evaluate the performance of the IDEA-RS in a prospective sample of adolescents participating in the IDEA Risk Stratified Cohort.
Using the IDEA-RS, we screened 7720 adolescents aged 14-16 years in 101 public schools in Porto Alegre, Brazil, and recruited 50 low-risk (LR) and 50 high-risk (HR) participants without depression. The incidence of depressive disorders over 3 years was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Statistical analysis involved Poisson regression with robust variance to estimate incidence rate ratios (IRRs) for depression onset.
In the HR group, 14/45 developed depression, in comparison to 5/43 in the LR group. Poisson regression analysis confirmed a higher probability of developing depression in the HR group compared with the LR group (IRR of 2.68, 95% CI 1.05 to 6.79, p=0.04).
In a prospective cohort of Brazilian adolescents, the IDEA-RS effectively distinguished between those at HR and LR for developing depression.
These results support the usefulness of an easy-to-administer sociodemographic composite risk score for stratifying the probability of developing depression among adolescents, a promising tool to be used in a variety of global contexts, including resource-limited settings.
青春期是预防抑郁症的关键时期，但以往的努力大多针对单一风险因素。青少年早期抑郁症识别风险评分（IDEA-RS）整合了易于获取的社会人口学变量，并且能够预测不同人群未来的抑郁症发病情况。然而，其在前瞻性队列中的表现尚未得到检验。
评估IDEA-RS在参与IDEA风险分层队列研究的青少年前瞻性样本中的表现。
我们使用IDEA-RS对巴西阿雷格里港101所公立学校的7720名14至16岁青少年进行筛查，招募了50名无抑郁症的低风险（LR）参与者和50名高风险（HR）参与者。使用儿童情感障碍和精神分裂症评定量表评估3年内抑郁症的发病率。统计分析采用稳健方差的泊松回归来估计抑郁症发病的发病率比（IRR）。
在高风险组中，45人中有14人患上抑郁症，而低风险组中43人中有5人患病。泊松回归分析证实，高风险组患抑郁症的可能性高于低风险组（IRR为2.68，95%CI为1.05至6.79，p=0.04）。
在巴西青少年的前瞻性队列中，IDEA-RS能够有效区分高风险和低风险的抑郁症发病情况。
这些结果支持了一种易于应用的社会人口学综合风险评分在分层青少年抑郁症发病概率方面的有效性。这是一种很有前景的工具，可用于包括资源有限环境在内的各种全球环境。
