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Open Access Research

Screening for depressed mood in an adolescent psychiatric context by brief self-assessment scales – testing psychometric validity of WHO-5 and BDI-6 indices by latent trait analyses

Eva Henje Blom12*, Per Bech3, Göran Högberg1, Jan Olov Larsson4 and Eva Serlachius1

Author Affiliations

1 Department of Clinical Neuroscience, Karolinska Institutet, Retzius väg 8, A2:3, Stockholm, 17177, Sweden

2 Psychiatric Research Unit Mental Health Centre North Zealand, Dyrehavevej 48, DK 3400, Hillerød, Denmark

3 Department of Women’s and Children’s Health, Building H2:00 Karolinska University Hospital, 171 76, Stockholm, Sweden

4 Department of Women’s and Children’s Health, Karolinska Institutet, Retzius väg 8, A2:3, Stockholm, 17177, Sweden

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Health and Quality of Life Outcomes 2012, 10:149  doi:10.1186/1477-7525-10-149

Published: 11 December 2012

Abstract

Background

Major depressive disorder is prevalent in the adolescent psychiatric clinical setting and often comorbid with other primary psychiatric diagnoses such as ADHD or social anxiety disorder. Systematic manual-based diagnostic procedures are recommended to identify such comorbidity but they are time-consuming and often not fully implemented in clinical practice. Screening for depressive symptoms in the child psychiatric context using brief, user-friendly and easily managed self-assessment scales may be of clinical value and utility. The aim of the study is to test the psychometric validity of two such scales, which may be used in a two-step screening procedure, the WHO-Five Well-being Index (WHO-5) and the six-item version of Beck’s Depression Inventory (BDI-6).

Method

66 adolescent psychiatric patients with a clinical diagnosis of major depressive disorder (MDD), 60 girls and 6 boys, aged 14–18 years, mean age 16.8 years, completed the WHO-5 scale as well as the BDI-6. Statistical validity was tested by Mokken and Rasch analyses.

Results

The correlation between WHO-5 and BDI-6 was −0.49 (p=0.0001). Mokken analyses showed a coefficient of homogeneity for the WHO-5 of 0.52 and for the BDI-6 of 0.46. Rasch analysis also accepted unidimensionality when testing males versus females (p > 0.05).

Conclusions

The WHO-5 is psychometrically valid in an adolescent psychiatric context including both genders to assess the wellness dimension and applicable as a first step in screening for MDD. The BDI-6 may be recommended as a second step in the screening procedure, since it is statistically valid and has the ability to unidimensionally capture the severity of depressed mood.

Keywords:
Well-being; Adolescent major depressive disorder; Rasch analyses; Mokken analyses; Brief self-assessment scales; BDI-6; WHO-5