A computerised screening instrument for adolescent depression: population-based validation and application to a two-phase case-control study

Soc Psychiatry Psychiatr Epidemiol. 1999 Mar;34(3):166-72. doi: 10.1007/s001270050129.

Abstract

Computer-administered questionnaires have been little explored as a potentially effective and inexpensive alternative to pencil and paper screening tests. A self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was compared with the Composite International Diagnostic Interview (CIDI) in a two-phase study of 2032 Australian high school students (mean age 15.7 years) drawn from a stratified random sample of 44 schools in the state of Victoria, Australia. Prevalence, sensitivity and specificity were estimated using weighting to compensate for the two-phase sampling. Point prevalence estimates of depression using the CIS-R were 1.8% for males and 5.6% for females--an overall prevalence of 3.2%. Prevalence estimates for depression in the past 6 months using the CIDI were 5.2% for males and 16.9% for females--an overall estimate of 12.1%. The CIS-R had a positive predictive value (PPV) of 0.49 and negative predictive value (NPV) of 0.91 for CIDI depression in the past 6 months. Specificity was very high (0.97) but sensitivity low (0.18), indicating that a majority of those with a CIDI-defined depressive episode in the past 6 months were not recognised at a single screening using the CIS-R. Even so, the CIS-R has proved at least as good as any pencil and paper questionnaire in identifying cases for nested case-control studies of adolescent depression. Further exploration of strategies such as serial screening to enhance sensitivity is warranted.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Algorithms
  • Australia / epidemiology
  • Case-Control Studies
  • Depression / diagnosis*
  • Depression / epidemiology*
  • Depression / prevention & control
  • Diagnosis, Computer-Assisted / instrumentation*
  • Diagnosis, Computer-Assisted / methods
  • Diagnosis, Computer-Assisted / standards
  • Female
  • Humans
  • Male
  • Mass Screening / instrumentation*
  • Predictive Value of Tests
  • Prevalence
  • Psychiatric Status Rating Scales / standards*
  • Psychology, Adolescent / statistics & numerical data*
  • Psychometrics
  • Sampling Studies
  • Surveys and Questionnaires