Thanita Pilunthanakul
Institute of Mental Health, Singapore
Title: A preliminary study examining the validity of the Patient Health Questionnaire 9-item in detecting depression in a multi-ethnic Asian population of adolescents with Autism Spectrum Disorder
Biography
Biography: Thanita Pilunthanakul
Abstract
Adolescents with Autism Spectrum Disorder (ASD) and comorbid depression may experience significant functional impairment and risk of suicidality. Screening and early detection is essential for timely treatment. The Patient Health Questionnaire 9-item (PHQ-9) is a brief and user-friendly screener with a cutoff score of 11 when assessing for depression symptoms in neuro-typical adolescents. However, given that the presentation of depression may differ in ASD, the current study aims to examine the validity of the PHQ-9 in detecting major depressive disorder (MDD) in adolescents with ASD.
Methods:
A total of 58 pairs of English-speaking adolescents with a diagnosis of ASD (M = 14.6, SD = 1.9), and their parents were enrolled. Participants completed the self- and parent-rated PHQ-9 independently, in addition to a demographics form. MDD was assessed using the Mini-International Neuropsychiatric Interview, Kid version, as the gold standard.
Results:
Self- and parent-rated PHQ-9 had a ROC area under the curve of 0.70 (95% CI: 0.49-0.91) and 0.61 (95% CI: 0.42-0.79), respectively. Self- and parent-rated PHQ-9 showed acceptable internal consistency (Cronbach’s α: 0.770 and 0.840, respectively) and convergent validity (r = 0.417, p < 0.01).
Conclusion:
Our preliminary findings suggest that the sensitivity and specificity of the PHQ-9 were suboptimal for adolescents with ASD using the current cutoff score, and that self- and parent-rated scores could be adjusted to 14 and 6, respectively. Parents tended to rate depressive symptoms at a lower severity level than the adolescents with ASD. However, our study was underpowered given the sample number of positive cases of MDD identified.