ABSTRACT
Objective: To evaluate psychometrically and provide crosswalks between 3 self-report measures of depressive symptomatology in youth in psychiatric care settings. Ratings included the Patient Health Questionnaire for Adolescents (PHQ-A), a widely used 9-item self-report; the 16-item Quick Inventory of Depressive Symptomatology–Self-Report (QIDS-SR16); and the 5-item Very Quick Inventory of Depressive Symptomatology–Self-Report (VQIDS-SR5), a recent effort to create a bridge from the QIDS-SR16 to clinical practice.
Methods: Data from the Texas Youth Depression and Suicide Research Network Registry (August 26, 2020–May 11, 2022) were included in this work. At first visit, 795 depressed or suicidal adolescent (12–20 years of age) psychiatric outpatients completed the PHQ-A, QIDS-SR16, and VQIDS-SR5. Classical test theory and item-response theory (IRT) analyses were conducted. Crosswalks among total scales were created. Sensitivity to change over 1-month follow-up was assessed for all 3 scales (n = 682).
Results: Cronbach alphas were 0.86 (PHQ-A), 0.80 (QIDS-SR16), and 0.76 (VQIDS-SR5). Item total correlations were 0.49–0.72, 0.29–0.64, and 0.43–0.61, respectively. All 3 scales were unidimensional and sensitive to change over a 1-month period. IRT analyses revealed satisfactory item performance. Modest but significant associations were found between baseline to 1-month changes in PHQ-A and VQIDS-SR5 total scores (r = 0.50, P < .0001) and between PHQ-A and QIDS-SR16 total scores (r = 0.56; P < .0001). Categorical thresholds of severity (ie, mild, moderate, severe, and very severe) were comparable between PHQ-A and QIDS-SR16.
Conclusions: The PHQ-A, QIDS-SR16, and VQIDS-SR5 are unidimensional, psychometrically acceptable self-reports of depressive prevalence or severity in adolescents and young adults in this sample. Total scale scores on any measure can be converted reliably to those on any other.
J Clin Psychiatry 2024;85(1):23m14861
Author affiliations are listed at the end of this article.
Continue Reading...
Did you know members enjoy unlimited free PDF downloads as part of their subscription? Subscribe today for instant access to this article and our entire library in your preferred format. Alternatively, you can purchase the PDF of this article individually.
References (48)
- Ghandour RM, Sherman LJ, Vladutiu CJ, et al. Prevalence and treatment of depression, anxiety, and conduct problems in US children. J Pediatr. 2019;206:256–267.e3. PubMed CrossRef
- Ryan ND. Treatment of depression in children and adolescents. Lancet. 2005;366(9489):933–940. PubMed CrossRef
- Thapar A, Collishaw S, Pine DS, et al. Depression in adolescence. Lancet. 2012;379(9820):1056–1067. www.ncbi.nlm.nih.gov/pmc/articles/PMC3488279/ PubMed CrossRef
- Thapar A, Eyre O, Patel V, et al. Depression in young people. Lancet. 2022;400(10352):617–631. PubMed CrossRef
- Costello EJ, Maughan B. Annual research review: optimal outcomes of child and adolescent mental illness. J Child Psychol Psychiatry. 2015;56(3):324–341. PubMed CrossRef
- Walter HJ, Abright AR, Bukstein OG, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. J Am Acad Child Adolesc Psychiatry. 2022;62(5):479–502. PubMed CrossRef
- Brent D, Emslie G, Clarke G, et al. Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. (published correction appears in JAMA. 2019 Nov 5;322(17) JAMA. 2008;299(8):901–913. PubMed CrossRef
- Merikangas KR, He JP, Burstein M, et al. Service utilization for lifetime mental disorders in US adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011;50(1):32–45. PubMed CrossRef
- Dwyer JB, Stringaris A, Brent DA, et al. Annual research review: defining and treating pediatric treatment-resistant depression. J Child Psychol Psychiatry. 2020;61(3):312–332. PubMed CrossRef
- Poznanski EO, Cook SC, Carroll BJ. A depression rating scale for children. Pediatrics. 1979;64(4):442–450. PubMed CrossRef
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. PubMed CrossRef
- Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134(4):382–389. PubMed CrossRef
- Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62. PubMed CrossRef
- Deshpande PR, Rajan S, Sudeepthi BL, et al. Patient-reported outcomes: a new era in clinical research. Perspect Clin Res. 2011;2(4):137–144. PubMed CrossRef
- Rush AJ, Giles DE, Schlesser MA, et al. The Inventory for Depressive Symptomatology (IDS): preliminary findings. Psychiatry Res. 1986;18(1):65–87. PubMed CrossRef
- Rush AJ, Gullion CM, Basco MR, et al. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med. 1996;26(3):477–486. PubMed CrossRef
- Rush AJ, Rago WV, Crismon ML, et al. Medication treatment for the severely and persistently mentally ill: the Texas Medication Algorithm Project. J Clin Psychiatry. 1999;60(5):284–291. PubMed CrossRef
- Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. (published correction appears in Biol Psychiatry. 2003 Sep 1;54(5) Biol Psychiatry. 2003;54(5):573–583. PubMed CrossRef
- Trivedi MH, Rush AJ, Wisniewski SR, et al; STAR*D Study Team. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28–40. PubMed CrossRef
- Fortney JC, Unützer J, Wrenn G, et al. A tipping point for measurement-based care. Psychiatr Serv. 2017;68(2):179–188. PubMed CrossRef
- Scott K, Lewis CC. Using measurement-based care to enhance any treatment. Cognit Behav Pract. 2015;22(1):49–59. PubMed CrossRef
- Rush AJ. Narrowing the gaps between what we know and what we do in psychiatry. J Clin Psychiatry. 2015;76(10):1366–1372. PubMed CrossRef
- Carmody TJ, Rush AJ, Bernstein IH, et al. Making clinicians lives easier: guidance on use of the QIDS self-report in place of the MADRS. J Affect Disord. 2006;95(1-3):115–118. PubMed CrossRef
- Rush AJ, Aaronson ST, Demyttenaere K. Difficult-to-treat depression: a clinical and research roadmap for when remission is elusive. Aust N Z J Psychiatry. 2019;53(2):109–118. PubMed CrossRef
- Rush AJ, Sackeim HA, Conway CR, et al. Clinical research challenges posed by difficult-to-treat depression. Psychol Med. 2022;52(3):419–432. PubMed CrossRef
- De La Garza N, John Rush A, Grannemann BD, et al. Toward a very brief self-report to assess the core symptoms of depression (VQIDS-SR5). Acta Psychiatr Scand. 2017;135(6):548–553. PubMed CrossRef
- Rush AJ, Madia ND, Carmody T, et al. Psychometric and Clinical Evaluation of the Clinician (VQIDS-C5) and Self-Report (VQIDS-SR5) Versions of the Very Quick Inventory of Depressive Symptoms. Neuropsychiatr Dis Treat. 2022;18:289–302. PubMed CrossRef
- Trivedi MH, Minhajuddin A, Slater H, et al. Texas Youth Depression and Suicide Research Network (TX-YDSRN) research registry and learning healthcare network: rationale, design, and baseline characteristics. J Affect Disord. 2023;340:88–99. PubMed CrossRef
- Johnson JG, Harris ES, Spitzer RL, et al. The Patient Health Questionnaire for Adolescents: validation of an instrument for the assessment of mental disorders among adolescent primary care patients. J Adolesc Health. 2002;30(3):196–204. PubMed CrossRef
- Wakefield JC. DSM-5: an overview of changes and controversies. Clin Soc Work J. 2013;41(2):139–154. CrossRef
- Bech P, Gram LF, Dein E, et al. Quantitative rating of depressive states. Acta Psychiatr Scand. 1975;51(3):161–170. PubMed CrossRef
- Bech P, Allerup P, Gram LF, et al. The Hamilton depression scale: evaluation of objectivity using logistic models. Acta Psychiatr Scand. 1981;63(3):290–299. PubMed CrossRef
- Bech P, Fava M, Trivedi MH, et al. Factor structure and dimensionality of the two depression scales in STAR*D using level 1 datasets. J Affect Disord. 2011;132(3):396–400. PubMed CrossRef
- Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(suppl 20):22–33, quiz 34–57. PubMed
- Nunnally JC, Bernstein IH. Psychometric Theory. 3rd ed. New York, NY: McGraw Hill; 1994.
- Humphreys LG, Montanelli RG Jr. An investigation of the parallel analysis criterion for determining the number of common factors. Multivariate Behav Res. 1975;10(2):193–205. CrossRef
- Samejima F. Graded Response Model. In: Van Der Linden WJ, Hambleton RK, eds. Handbook of Modern Item Response Theory. Springer; 1997:85–100.
- Thissen D, Chen WH, Bock RD. MULTILOG 7 for Windows: Multiple Category Item Analysis and Test Scoring using Item Response Theory [Computer Program]. Lincolnwood, IL: Scientific Software International; 2003.
- Orlando M, Sherbourne CD, Thissen D. Summed-score linking using item response theory: application to depression measurement. Psychol Assess. 2000;12(3):354–359. PubMed CrossRef
- Birnbaum A. Some latent trait models and their use in inferring an examinee’s ability. In: Lord FM, Novick MR, eds. Statistical Theories of Mental Test Scores. Reading, MA: Addison-Wesley; 1968.
- Sung SC, Low CC, Fung DS, et al. Screening for major and minor depression in a multiethnic sample of Asian primary care patients: a comparison of the nine-item Patient Health Questionnaire (PHQ-9) and the 16-item Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR16). Asia-Pac Psychiatry. 2013;5(4):249–258. PubMed CrossRef
- Feng Y, Huang W, Tian TF, et al. The psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and the Patient Health Questionnaire-9 (PHQ-9) in depressed inpatients in China. Psychiatry Res. 2016;243:92–96. PubMed CrossRef
- Baker F. The Basics of Item Response Theory. ERIC Clearinghouse on Assessment and Evaluation. University of Maryland; 2001.
- Zhang WY, Zhao YJ, Zhang Y, et al. Psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) in depressed adolescents. Front Psychiatry. 2020;11:598609. PubMed CrossRef
- Haley CL, Kennard BD, Bernstein IH, et al. Improving Depressive Symptom Measurement in Adolescents: A Psychometric Evaluation of the Quick Inventory of Depressive Symptomatology, Adolescent Version (Qids-A17); 2009, unpublished dissertation.
- Faedda GL, Marangoni C, Serra G, et al. Precursors of bipolar disorders: a systematic literature review of prospective studies. J Clin Psychiatry. 2015;76(5):614–624. PubMed CrossRef
- Diler RS, Goldstein TR, Hafeman D, et al. Distinguishing bipolar depression from unipolar depression in youth: preliminary findings. J Child Adolesc Psychopharmacol. 2017;27(4):310–319. PubMed CrossRef
- Serra G, Iannoni ME, Trasolini M, et al. Characteristics associated with depression severity in 270 juveniles in a major depressive episode. Brain Sci. 2021;11(4):440. PubMed CrossRef
Advertisement
GAM ID: sidebar-top