Adolescent depression beyond DSM definition: a network analysis

Authors

Pedro H. Manfro, Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 400N, Porto Alegre, RS, 90035-903, Brazil.
Rivka B. Pereira, Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 400N, Porto Alegre, RS, 90035-903, Brazil.
Martha Rosa, Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 400N, Porto Alegre, RS, 90035-903, Brazil.
Hugo Cogo-Moreira, Faculty of Teacher Education and Languages, Department of Education, ICT and Learning, Østfold University College, Halden, Norway.
Helen L. Fisher, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. helen.2.fisher@kcl.ac.uk.
Brandon A. Kohrt, Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Valeria Mondelli, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Christian Kieling, Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 400N, Porto Alegre, RS, 90035-903, Brazil.

Document Type

Journal Article

Publication Date

5-1-2023

Journal

European child & adolescent psychiatry

Volume

32

Issue

5

DOI

10.1007/s00787-021-01908-1

Keywords

Adolescence; Depressive symptoms; Diagnostic and statistical manual of mental disorders; Patient outcome assessment; Psychometrics

Abstract

Calls for refining the understanding of depression beyond diagnostic criteria have been growing in recent years. We examined the prevalence and relevance of DSM and non-DSM depressive symptoms in two Brazilian school-based adolescent samples with two commonly used scales, the Patient Health Questionnaire (PHQ-A) and the Mood and Feelings Questionnaire (MFQ). We analyzed cross-sectional data from two similarly recruited samples of adolescents aged 14-16 years, as part of the Identifying Depression Early in Adolescence (IDEA) study in Brazil. We assessed dimensional depressive symptomatology using the PHQ-A in the first sample (n = 7720) and the MFQ in the second sample (n = 1070). We conducted network analyses to study symptom structure and centrality estimates of the two scales. Additionally, we compared centrality of items included (e.g., low mood, anhedonia) and not included in the DSM (e.g., low self-esteem, loneliness) in the MFQ. Sad mood and worthlessness items were the most central items in the network structure of the PHQ-A. In the MFQ sample, self-hatred and loneliness, two non-DSM features, were the most central items and DSM and non-DSM items in this scale formed a highly interconnected network of symptoms. Furthermore, analysis of the MFQ sample revealed DSM items not to be more frequent, severe or interconnected than non-DSM items, but rather part of a larger network of symptoms. A focus on symptoms might advance research on adolescent depression by enhancing our understanding of the disorder.

APA Citation

Manfro, Pedro H.; Pereira, Rivka B.; Rosa, Martha; Cogo-Moreira, Hugo; Fisher, Helen L.; Kohrt, Brandon A.; Mondelli, Valeria; and Kieling, Christian, "Adolescent depression beyond DSM definition: a network analysis" (2023). GW Authored Works. Paper 3000.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3000

Department

Psychiatry and Behavioral Sciences