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Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents.

Publication ,  Journal Article
Rocha, TB-M; Fisher, HL; Caye, A; Anselmi, L; Arseneault, L; Barros, FC; Caspi, A; Danese, A; Gonçalves, H; Harrington, HL; Houts, R ...
Published in: Journal of the American Academy of Child and Adolescent Psychiatry
February 2021

Prediction models have become frequent in the medical literature, but most published studies are conducted in a single setting. Heterogeneity between development and validation samples has been posited as a major obstacle for the generalization of models. We aimed to develop a multivariable prognostic model using sociodemographic variables easily obtainable from adolescents at age 15 to predict a depressive disorder diagnosis at age 18 and to evaluate its generalizability in 2 samples from diverse socioeconomic and cultural settings.Data from the 1993 Pelotas Birth Cohort were used to develop the prediction model, and its generalizability was evaluated in 2 representative cohort studies: the Environmental Risk (E-Risk) Longitudinal Twin Study and the Dunedin Multidisciplinary Health and Development Study.At age 15, 2,192 adolescents with no evidence of current or previous depression were included (44.6% male). The apparent C-statistic of the models derived in Pelotas ranged from 0.76 to 0.79, and the model obtained from a penalized logistic regression was selected for subsequent external evaluation. Major discrepancies between the samples were identified, impacting the external prognostic performance of the model (Dunedin and E-Risk C-statistics of 0.63 and 0.59, respectively). The implementation of recommended strategies to account for this heterogeneity among samples improved the model's calibration in both samples.An adolescent depression risk score comprising easily obtainable predictors was developed with good prognostic performance in a Brazilian sample. Heterogeneity among settings was not trivial, but strategies to deal with sample diversity were identified as pivotal for providing better risk stratification across samples. Future efforts should focus on developing better methodological approaches for incorporating heterogeneity in prognostic research.

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Published In

Journal of the American Academy of Child and Adolescent Psychiatry

DOI

EISSN

1527-5418

ISSN

0890-8567

Publication Date

February 2021

Volume

60

Issue

2

Start / End Page

262 / 273

Related Subject Headings

  • Prognosis
  • Male
  • Longitudinal Studies
  • Humans
  • Female
  • Developmental & Child Psychology
  • Depression
  • Cohort Studies
  • Brazil
  • Adolescent
 

Citation

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Chicago
ICMJE
MLA
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Rocha, T.-M., Fisher, H. L., Caye, A., Anselmi, L., Arseneault, L., Barros, F. C., … Kieling, C. (2021). Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents. Journal of the American Academy of Child and Adolescent Psychiatry, 60(2), 262–273. https://doi.org/10.1016/j.jaac.2019.12.004
Rocha, Thiago Botter-Maio, Helen L. Fisher, Arthur Caye, Luciana Anselmi, Louise Arseneault, Fernando C. Barros, Avshalom Caspi, et al. “Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents.Journal of the American Academy of Child and Adolescent Psychiatry 60, no. 2 (February 2021): 262–73. https://doi.org/10.1016/j.jaac.2019.12.004.
Rocha TB-M, Fisher HL, Caye A, Anselmi L, Arseneault L, Barros FC, et al. Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents. Journal of the American Academy of Child and Adolescent Psychiatry. 2021 Feb;60(2):262–73.
Rocha, Thiago Botter-Maio, et al. “Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents.Journal of the American Academy of Child and Adolescent Psychiatry, vol. 60, no. 2, Feb. 2021, pp. 262–73. Epmc, doi:10.1016/j.jaac.2019.12.004.
Rocha TB-M, Fisher HL, Caye A, Anselmi L, Arseneault L, Barros FC, Caspi A, Danese A, Gonçalves H, Harrington HL, Houts R, Menezes AMB, Moffitt TE, Mondelli V, Poulton R, Rohde LA, Wehrmeister F, Kieling C. Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in 3 Different Continents. Journal of the American Academy of Child and Adolescent Psychiatry. 2021 Feb;60(2):262–273.
Journal cover image

Published In

Journal of the American Academy of Child and Adolescent Psychiatry

DOI

EISSN

1527-5418

ISSN

0890-8567

Publication Date

February 2021

Volume

60

Issue

2

Start / End Page

262 / 273

Related Subject Headings

  • Prognosis
  • Male
  • Longitudinal Studies
  • Humans
  • Female
  • Developmental & Child Psychology
  • Depression
  • Cohort Studies
  • Brazil
  • Adolescent