New Tool to Diagnose Adolescent Depression

The Centers for Disease Control and Prevention (CDC) estimates that between 1992 to 2004, the rate of hospitalization for depression has increased approximately 81% for females and 30% for males aged 5-19 years. In 2004, more than 5,000 US children and adolescents committed suicide and an additional 171,870 non-fatal self harm injury cases were reported. About 15-20% of American teens have experienced a serious episode of depression, which is similar to the proportion of depressed adults.

Eighty percent of the depression cases are readily treatable. But the numbers above state a different story. One possible reason could be improper diagnosis. Depression in adolescents can occur due stress associated with the normal maturation process. It can also occur as a result of a traumatic experience. It is however, difficult to diagnose depression in adolescents because it may manifest in several forms and can also be mistaken for normal teenage behavior.

Over the years, several different methods have been used to diagnose depression along with the physical examination. These include self-reports like the Center for Epidemiological Studies Depression Scale and Beck Depression Inventory and clinician reports like the Hamilton Depression Rating Scale and the Children’s Depression Rating Scale. These scales however, are not specific to adolescents and hence have been reported to have limited reliability in that age group. Also, these tests classify adolescents as either depressed or not depression and do not consider a substantial number of depressed teens with no apparent symptoms. Thus, some recently published studies have supported a dimensional model where depression is graded along a continuum from mild to severe.

In a study published recently in BMC Psychiatry, Dr. Revah-Levy et al. of the Université Paris Sud designed and tested a dimensional scale to diagnose adolescent depression called the Adolescent Depression Rating Scale (ADRS). Two initial versions of ADRS were constructed: one was a 11 item clinician-scale report and the other was a 44 item self-report scale. 402 adolescents were assessed and it was found that ADRS had acceptable psychometric properties.

This test has only been validated in French as of now but translations are being made into other languages. If successful, this can make a considerable difference in the way adolescent depression is diagnosed and that may in turn lead to better management of the disease and save so many young lives.

Reference

Anne Revah-Levy, Boris Birmaher, Isabelle Gasquest, and Bruno Falissard. The Adolescent Depression Rating Scale: a validation study. BMC Psychiatry 2007, 7:2.