<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjcapp-2014-004_s_001"><h3>Background:</h3><p>The diagnosis of major depressive disorder (MDD), according to the <italic toggle="yes">Diagnostic and Statistical Manual of Mental Disorders</italic>, 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.</p></sec><sec id="j_sjcapp-2014-004_s_002"><h3>Methods:</h3><p>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.</p></sec><sec id="j_sjcapp-2014-004_s_003"><h3>Results:</h3><p>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 <italic toggle="yes">Diagnostic and Statistical Manual of Mental Disorders</italic> 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.</p></sec><sec id="j_sjcapp-2014-004_s_004"><h3>Limitations:</h3><p>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.</p></sec><sec id="j_sjcapp-2014-004_s_005"><h3>Conclusions:</h3><p>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 <italic toggle="yes">Diagnostic and Statistical Manual of Mental Disorders</italic> during the diagnostic process of adolescent depression is questioned.</p></sec></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.

Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents"}

Background:The diagnosis of major depressive disorder (MDD), according to the Diagnostic and Statistical Manual of Mental Disorders, is based only on adult...

Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents

Article Category: research-article

Published Online: Nov 30, 2013

Page range: 19 - 28

DOI: https://doi.org/10.21307/sjcapp-2014-004

Keywords
Adolescent major depressive disorder, diagnostic validity, latent class analysis

© 2014 Eva Henje Blom et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents

Article Category: research-article

Published Online: Nov 30, 2013

Page range: 19 - 28

DOI: https://doi.org/10.21307/sjcapp-2014-004

KeywordsAdolescent major depressive disorder, diagnostic validity, latent class analysis

© 2014 Eva Henje Blom et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
Adolescent major depressive disorder, diagnostic validity, latent class analysis