Open Access Research article

Detecting depression among adolescents in Santiago, Chile: sex differences

Ricardo Araya1*, Jesus Montero-Marin2, Sergio Barroilhet3, Rosemarie Fritsch45 and Alan Montgomery1

Author Affiliations

1 School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2PS, UK

2 Department of Psychiatry, University of Zaragoza, Zaragoza, Spain

3 School of Psychology, University of the Andes, Santiago, Chile

4 Department of Psychiatry and Mental Health, University of Chile Clinical Hospital, Santiago, Chile

5 Department of Psychiatry, Faculty of Medicine, University of the Andes, Santiago, Chile

For all author emails, please log on.

BMC Psychiatry 2013, 13:122  doi:10.1186/1471-244X-13-122

Published: 23 April 2013

Abstract

Background

Depression among adolescents is common but most cases go undetected. Brief questionnaires offer an opportunity to identify probable cases but properly validated cut-off points are often unavailable, especially in non-western countries. Sex differences in the prevalence of depression become marked in adolescence and this needs to be accounted when establishing cut-off points.

Method

This study involved adolescents attending secondary state schools in Santiago, Chile. We compared the self-reported Beck Depression Inventory-II with a psychiatric interview to ascertain diagnosis. General psychometric features were estimated before establishing the criterion validity of the BDI-II.

Results

The BDI-II showed good psychometric properties with good internal consistency, a clear unidimensional factorial structure, and good capacity to discriminate between cases and non-cases of depression. Optimal cut-off points to establish caseness for depression were much higher for girls than boys. Sex discrepancies were primarily explained by differences in scores among those with depression rather than among those without depression.

Conclusions

It is essential to validate scales with the populations intended to be used with. Sex differences are often ignored when applying cut-off points, leading to substantial misclassification. Early detection of depression is essential if we think that early intervention is a clinically important goal.

Keywords:
Depression; Adolescents; Sex; Beck depression inventory; Screening