No abstract

The Center for Epidemiological Studies-Depression (CES-D) Scale's 20-item version is well-validated and reliable for detecting depressive symptoms in adolescents in community samples. A shortened version, CES-D 10 has not been validated with adolescents, but has demonstrated strong psychometrics in other populations. The purpose of this study was to test the factorial validity and internal consistency of the CES-D 10 in adolescents. Using data from 156 adolescents in a previous community-based study, we tested three models of the underlying factors of the CES-D 10 using Structural Equation Modeling (SEM) based on factor models validated in other populations. A two-factor model comprised of depressive affect and positive affect was found to be the model that best fits the data (RMSEA = 0.016, CFI = 0.98, GFI = 0.95, AIC = 97.43, BIC = 191.98). These findings are consistent with other studies in adults and provide initial support for the use of the CES-D 10 as a depression screen for adolescents in the community. The utility of a brief screen for adolescents in the community is high, given that many adolescents do not know they need help or are reluctant to seek help. The CES-D 10 could be used as a depression screen for adolescents at a population level and in health clinics.

No abstract

BackgroundSevere mental illness (SMI), including schizophrenia, bipolar disorder and severe depression, is responsible for a substantial proportion of disability in the population. This article describes the aims and design of a research study that takes a novel approach to targeted prevention of SMI. It is based on the rationale that early developmental antecedents to SMI are likely to be more malleable than fully developed mood or psychotic disorders and that low-risk interventions targeting antecedents may reduce the risk of SMI.Methods/DesignFamilies Overcoming Risks and Building Opportunities for Well-being (FORBOW) is an accelerated cohort study that includes a large proportion of offspring of parents with SMI and embeds intervention trials in a cohort multiple randomized controlled trial (cmRCT) design. Antecedents are conditions of the individual that are distressing but not severely impairing, predict SMI with moderate-to-large effect sizes and precede the onset of SMI by at least several years. FORBOW focuses on the following antecedents: affective lability, anxiety, psychotic-like experiences, basic symptoms, sleep problems, somatic symptoms, cannabis use and cognitive delay. Enrolment of offspring over a broad age range (0 to 21 years) will allow researchers to draw conclusions on a longer developmental period from a study of shorter duration. Annual assessments cover a full range of psychopathology, cognitive abilities, eligibility criteria for interventions and outcomes. Pre-emptive early interventions (PEI) will include skill training for parents of younger children and courses in emotional well-being skills based on cognitive behavioural therapy for older children and youth. A sample enriched for familial risk of SMI will enhance statistical power for testing the efficacy of PEI.DiscussionFORBOW offers a platform for efficient and unbiased testing of interventions selected according to best available evidence. Since few differences exist between familial and ’sporadic’ SMI, the same interventions are likely to be effective in the general population. Comparison of short-term efficacy of PEI on antecedents and the long term efficacy for preventing the onset of SMI will provide an experimental test of the etiological role of antecedents in the development of SMI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0344-2) contains supplementary material, which is available to authorized users.