Assessing a prediction model for depression risk using an early adolescent sample with self-reported depression

IF 3.1
JCPP advances Pub Date : 2024-09-03 DOI:10.1002/jcv2.12276
Eileen Y. Xu, Niamh MacSweeney, Gladi Thng, Miruna C. Barbu, Xueyi Shen, Alex S. F. Kwong, Liana Romaniuk, Andrew McIntosh, Stephen M. Lawrie, Heather C. Whalley
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引用次数: 0

Abstract

Background

Major depressive disorder (MDD) in adolescence is a risk factor for poor physical and psychiatric outcomes in adulthood, with earlier age of onset associated with poorer outcomes. Identifying Depression Early in Adolescence Risk Score (IDEA-RS) is a model for predicting MDD in youth aged >15 years, but replication in younger samples (<15 years) is lacking. Here, we tested IDEA-RS in a younger sample (9–11 years) to assess whether IDEA-RS could be applied to earlier onset depression.

Methods

We applied IDEA-RS predictor weights to 9854 adolescents (9–11 years) from the Adolescent Brain Cognitive Development (ABCD) Study, United States. We derived incident depression outcomes from self-reported data at 2-year follow-up (11–13 years): incident MDD and increase in depression symptoms (DS). Sensitivity analyses were conducted using parent-reported data. We assessed accuracy and calibration in predicting self-reported incident depression and compared this to a refitted model with predictor weights derived in ABCD. Lastly, we tested associations between IDEA-RS predictors and self-reported incident depression.

Results

External replication yielded better-than-chance discriminative capacity for self-reported incident depression (MDD: AUC = 61.4%, 95% CI = 53.5%–69.4%; DS: AUC = 57.9%, 95% CI = 54.6%–61.3%) but showed poor calibration with overly extreme risk estimates. Re-estimating predictor weights improved discriminative capacity (MDD: AUC = 75.9%, 95% CI = 70.3%–81.4%; DS: AUC = 64.8%, 95% CI = 61.9%–67.7%) and calibration. IDEA-RS predictors ‘poorest level of relationship with the primary caregiver’ (OR = 4.25, 95% CI = 1.73–10.41) and ‘high/highest levels of family conflict’ (OR = 3.36 [95% CI = 1.34–8.43] and OR = 3.76 [95% CI = 1.50–9.38], respectively) showed greatest associations with self-reported incident MDD.

Conclusions

While IDEA-RS yields better-than-chance predictions on external replication, accuracy is improved when differences between samples, such as case-control mix, are adjusted for. IDEA-RS may be more suited to research settings with sufficient data for refitting. Altogether, we find that IDEA-RS can be generalisable to early adolescents after refitting and that family dysfunction may be especially impactful for this period of development.

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使用自我报告抑郁的早期青少年样本评估抑郁风险的预测模型
背景青春期的重度抑郁症(MDD)是成年期不良身体和精神预后的一个危险因素,发病年龄越早,预后越差。识别青少年早期抑郁风险评分(IDEA-RS)是一个预测15岁青少年重度抑郁症的模型,但在更年轻的样本(15岁)中缺乏复制。在这里,我们在一个更年轻的样本(9-11岁)中测试了IDEA-RS,以评估IDEA-RS是否可以应用于早发性抑郁症。方法应用IDEA-RS预测因子权重对9854名来自美国青少年大脑认知发展(ABCD)研究的9-11岁青少年进行分析。我们从2年随访(11-13年)的自我报告数据中得出了事件抑郁结局:事件重度抑郁症和抑郁症状(DS)的增加。使用家长报告的数据进行敏感性分析。我们评估了预测自我报告的抑郁事件的准确性和校准,并将其与ABCD中导出的预测因子权重的修正模型进行了比较。最后,我们测试了IDEA-RS预测因子与自我报告的事件抑郁症之间的关联。结果外部复制对自述事件抑郁症的判别能力优于随机(MDD: AUC = 61.4%, 95% CI = 53.5% ~ 69.4%;DS: AUC = 57.9%, 95% CI = 54.6%-61.3%),但显示校准不良,风险估计过于极端。重新估计预测因子权重可提高判别能力(MDD: AUC = 75.9%, 95% CI = 70.3% ~ 81.4%;DS: AUC = 64.8%, 95% CI = 61.9% -67.7%)和校准。IDEA-RS预测因子“与主要照顾者关系最差水平”(OR = 4.25, 95% CI = 1.73-10.41)和“家庭冲突高/最高水平”(OR = 3.36 [95% CI = 1.34-8.43]和OR = 3.76 [95% CI = 1.50-9.38])与自述的重度抑郁症事件关联最大。虽然IDEA-RS对外部复制的预测优于随机预测,但在调整了样本之间的差异(如病例-对照混合)后,准确性得到了提高。IDEA-RS可能更适合有足够数据进行改装的研究环境。总之,我们发现IDEA-RS可以推广到早期青少年改装后,家庭功能障碍可能特别影响这一发展时期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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