title: 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.
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).
  
  
  METHODS
  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.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Retzius väg 8, A2:3, Stockholm 17177, Sweden. eva.henjeblom@ki.se
authors.forename: Eva Henje
authors.initials: EH
authors.lastname: Blom
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.forename: Göran
authors.initials: G
authors.lastname: Högberg
authors.forename: Jan Olov
authors.initials: JO
authors.lastname: Larsson
authors.forename: Eva
authors.initials: E
authors.lastname: Serlachius
mesh_terms: D000293:Adolescent; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D015233:Models, Statistical; D010549:Personal Satisfaction; D011594:Psychometrics; D011795:Surveys and Questionnaires / Q000592:standards*