Latent classes of symptoms related to clinically depressed mood in adolescents
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Abstract Background: The diagnosis of major depressive disorder (MDD), according to the Diagnostic and Statistical Manual of Mental Disorders , is based only on adult symptomatology of depression and not adapted for age and gender. This may contribute to the low diagnostic specificity and validity of adolescent MDD. In this study, we investigated whether latent classes based on symptoms associated with depressed mood could be identified in a sample of adolescents seeking psychiatric care, regardless of traditionally defined diagnostic categories. Methods: Self-reports of the Strengths and Difficulties Questionnaire and the Development and Well-Being Assessment were collected consecutively from all new patients between the ages of 13 and 17 years at two psychiatric outpatient clinics in Stockholm, Sweden. Those who reported depressed mood at intake yielded a sample of 21 boys and 156 girls. Latent class analyses were performed for all screening items and for the depression-specific items of the Development and Well-Being Assessment. Results: The symptoms that were reported in association with depressed mood differentiated the adolescents into two classes. One class had moderate emotional severity scores on the Strengths and Difficulties Questionnaire and mainly symptoms that were congruent with the Diagnostic and Statistical Manual of Mental Disorders criteria for MDD. The other class had higher emotional severity scores and similar symptoms to those reported in the first class. However, in addition, this group demonstrated more diverse symptomatology, including vegetative symptoms, suicidal ideation, anxiety, conduct problems, body dysmorphic symptoms, and deliberate vomiting. The classes predicted functional impairment in that the members of the second class showed more functional impairment. Limitations: The relatively small sample size limited the generalizability of the results of this study, and the amount of items included in the analysis was restricted by the rules of latent class analysis. No conclusions about gender differences between the classes could be could be drawn as a result of the low number of boys included in the study. Conclusions: Two distinct classes were identified among adolescents with depressed mood. The class with highest emotional symptom severity score and the most functional impairment had a more diverse symptomatology that included symptoms that were not congruent with the traditional diagnostic criteria of MDD. However, this additional symptomatology is clinically important to consider. As a result, the clinical usefulness of the Diagnostic and Statistical Manual of Mental Disorders during the diagnostic process of adolescent depression is questioned.
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DSM diagnostic criteria for adolescent MDD have low diagnostic validity and specificity, resulting in unclear diagnostic boundaries especially with regard to generalized and social anxiety.
“the DSM diagnostic criteria for adolescent MDD have low diagnostic validity and specificity, resulting in unclear diagnostic boundaries especially with regard to generalized and social anxiety”
From Feasibility and preliminary efficacy of a novel RDoC-based treatment program for adolescent depression: "Training for Awareness Resilience and Action" (TARA)-A pilot study (2017) · cites this paper as [13]
The Discussion (page unavailable) says DSM criteria for adolescent MDD have low diagnostic validity and specificity, and the Introduction describes unclear diagnostic boundaries and symptom overlap with generalized anxiety disorder. The Results and Discussion report social anxiety symptoms among adolescents with depressed mood, but do not specifically identify social anxiety as a diagnostic-boundary problem or establish that these two anxiety conditions are especially problematic compared with others. (LLM, conf=0.83)
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- Authors
- Blom, E. H., Forsman, M., Yang, T. T., Serlachius, E., & Larsson, J.-O.
- Affiliations
- Department of Clinical Neuroscience, Karolinska Institutet , Solna , Sweden
- Karolinska Institutet (SE)
- Venue
- Scandinavian Journal of Child and Adolescent Psychiatry and Psychology
- Publisher
- Walter de Gruyter GmbH
- Published
- 2013-11-30
- Volume
- 2
- Issue
- 1
- Pages
- 19-28
- ISSN
- 2245-8875 (ISSN-L)
- PMC
- PMC4236828
- OpenAlex
- W1603135250
- Cited by
- 18
- References
- 61
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 2 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Scandinavian Journal of Child and Adolescent Psychiatry and Psychology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Mental Health (R01MH085734)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- adolescent depression, major depressive disorder, depressive mood, DSM diagnostic criteria, Strengths and Difficulties Questionnaire, Development and Well-Being Assessment, functional disability, suicidal ideation, body dysmorphic symptoms, anxiety, conduct problems, psychiatric outpatients
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