Predicting depressive and anxiety disorders with the YASR internalising scales (empirical and DSM-oriented)

Abstract

Background: The Achenbach problem behaviour scales (CBCL/YSR) are widely used. The DSM-oriented anxiety and depression scales have been created to improve concordance between Achenbach's internalising scales and DSM-IV depression and anxiety. To date no study has examined the concurrent utility of the young adult (YASR) internalising scales, either the empirical or newly developed DSM-oriented depressive or anxiety scales.

Methods: A sample of 2,551 young adults, aged 18-23 years, from an Australian cohort study. The association between the empirical and DSM-oriented anxiety and depression scales were individually assessed against DSM-IV depression and anxiety diagnoses derived from structured interview. Odds ratios, ROC analyses and diagnostic efficiency tests (sensitivity, specificity, positive and negative predictive values) were used to report findings.

Results: YASR empirical internalising scale predicted DSM-IV mood disorders (depression OR = 6.9, 95% CI 5.0-9.5; anxiety OR = 5.1, 95% CI 3.8-6.7) in the previous 12 months. DSM-oriented depressive or anxiety scales did not appear to improve the concordance with DSM-IV diagnosed depression or anxiety. The internalising scales were much more effective at identifying those with comorbid depression and anxiety, with ORs between 10.1 and 21.7 depending on the internalising scale used.

Conclusion: DSM-oriented scales perform no better than the standard internalising in identifying young adults with DSM-IV mood or anxiety disorder.