title: Depression and suicidal behavior in adolescents: a multi-informant and multi-methods approach to diagnostic classification.
abstract: BACKGROUND
  Informant discrepancies have been reported between parent and adolescent measures of depressive disorders and suicidality. We aimed to examine the concordance between adolescent and parent ratings of depressive disorder using both clinical interview and questionnaire measures and assess multi-informant and multi-method approaches to classification.
  
  
  METHODS
  Within the context of assessment of eligibility for a randomized clinical trial, 50 parent-adolescent pairs (mean age of adolescents = 15.0 years) were interviewed separately with a structured diagnostic interview for depression, the KID-SCID. Adolescent self-report and parent-report versions of the Strengths and Difficulties Questionnaire, the Short Mood and Feelings Questionnaire and the Depressive Experiences Questionnaire were also administered. We examined the diagnostic concordance rates of the parent vs. adolescent structured interview methods and the prediction of adolescent diagnosis via questionnaire methods.
  
  
  RESULTS
  Parent proxy reporting of adolescent depression and suicidal thoughts and behavior is not strongly concordant with adolescent report. Adolescent self-reported symptoms on depression scales provide a more accurate report of diagnosable adolescent depression than parent proxy reports of adolescent depressive symptoms. Adolescent self-report measures can be combined to improve the accuracy of classification. Parents tend to over report their adolescent's depressive symptoms while under reporting their suicidal thoughts and behavior.
  
  
  CONCLUSIONS
  Parent proxy report is clearly less reliable than the adolescent's own report of their symptoms and subjective experiences, and could be considered inaccurate for research purposes. While parent report would still be sought clinically where an adolescent refuses to provide information, our findings suggest that parent reporting of adolescent suicidality should be interpreted with caution.
authors.affiliation: School of Psychology, Deakin University Melbourne, VIC, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lewis
authors.affiliation: School of Psychology, Deakin University Melbourne, VIC, Australia.
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Bertino
authors.affiliation: School of Psychology, Deakin University Melbourne, VIC, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bailey
authors.affiliation: School of Psychology, Deakin University Melbourne, VIC, Australia.
authors.forename: Joanna
authors.initials: J
authors.lastname: Skewes
authors.affiliation: Eastern Health Clinical School, Turning Point, Monash University Melbourne, VIC, Australia.
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
authors.affiliation: School of Psychology, Deakin University Melbourne, VIC, Australia.
authors.forename: John W
authors.initials: JW
authors.lastname: Toumbourou
keywords: adolescent depression; classification; parent-child relations; psychiatric diagnosis; suicide
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