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Cited by 66Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Predicting future risk of depressive episode in adolescents: the Chicago Adolescent Depression Risk Assessment (CADRA)

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Van Voorhees, B. W., Paunesku, D., Gollan, J., Kuwabara, S., Reinecke, M., Basu, A.·2008·The Annals of Family Medicine
DOI 10.1370/afm.887PMC PMC2582469
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Abstract

PURPOSE: A risk prediction index, similar to those used for other disorders, such as cardiovascular disease, would facilitate depression prevention by identifying those who would benefit most from preventative measures in primary care settings. METHODS: The National Longitudinal Study of Adolescent Health enrolled a representative sample of US adolescents and included a baseline survey in 1995 and a 1-year follow-up survey in 1996 (n = 4,791). We used baseline risk factors (social and cognitive vulnerability and mood) to predict onset of a depressive episode at 1-year follow-up (eg, future risk of episode) and used boosted classification and regression trees to develop a prediction index, The Chicago Adolescent Depression Risk Assessment, suitable for a personal computer or hand-held device. True and false positives and negatives were determined based on concordance and discordance, respectively, between the prediction-category-based index and actual classification-category-based 1-year follow-up outcome. We evaluated the performance of the index for the entire sample and with several depressive episode outcomes using the standard Center for Epidemiologic Studies Depression (CES-D) scale cutoffs. RESULTS: The optimal prediction model (including depressed mood and social vulnerability) was a 20-item model with an area under the receiver operating characteristics curve of 0.80 (95% CI, 0.714-0.870), a sensitivity of 75%, and a specificity of 76.5%. For depressive episode, the positive predictive values in the highest risk group (level 4) was from 13.75% for a depressive episode to 63.57% for CES-D score of greater than 16 (mild to moderate depressed mood or above) at follow-up. Conversely, the negative predictive value of being in the lowest 2 levels (0 or 1) was 99.38% for a depressive episode and 89.19% for a CES-D score of greater than 16. CONCLUSIONS: Our model predicts a depressive episode and other depressive outcomes at 1-year follow-up. Positive and negative predictive values could enable primary care physicians and families to intervene on adolescents at highest risk.

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Research works printed but not linked: 4

  1. Kessler RC, Walters EE. Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depress Anxiety. 1998;7(1):3-14.
  2. Van Voorhees BWEJ, Stuart S, Fogel J, Ford D. Pilot study of a pri- mary care depression prevention intervention for late adolescents. J Canad Child Adolesc Psyc Rev. 2005;14(2):40-43.
  3. Reinecke M, Simons A. Vulnerability to depression among ado- lescents: implications for cogntive treatment. Cognit Behav Pract. 2005;12:166-176.
  4. Friedman J, Hastie T, Tibshirani R. Additive logistic regression: a statistical vie of boosting. Ann Stat. 2000;28(2):337-407.

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Authors
Van Voorhees, B. W., Paunesku, D., Gollan, J., Kuwabara, S., Reinecke, M., & Basu, A.
Affiliations
  • University of Chicago (US)
  • Northwestern University (US)
  • Johns Hopkins University (US)
ORCID
Venue
The Annals of Family Medicine
Publisher
Annals of Family Medicine
Published
2008-11-01
Volume
6
Issue
6
Pages
503-511
ISSN
  • 1544-1709 (ISSN-L)
  • 1544-1717
DOI
10.1370/afm.887
PMC
PMC2582469
OpenAlex
W2142334664
Cited by
65
References
58
Citations by year
2025: 4 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 1 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 5 · 2014: 3 · 2013: 3 · 2012: 1
FWCI
4.86
Type
journal article
Language
en
Open access
Locations
  • The Annals of Family Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (K08MH072918)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
adolescent depression, depressive mood, social vulnerability, cognitive vulnerability, depression prevention, primary care, CES-D depression scale, Add Health
MeSH terms
Adolescent, Psychology, Adolescent, Child, Data Interpretation, Statistical, Depressive Disorder, Female, Health Surveys, Humans, Longitudinal Studies, Male, Predictive Value of Tests, Primary Health Care, Reproducibility of Results, Models, Statistical, Risk Assessment, Young Adult

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