The combined self- and parent-rated SDQ score profile predicts care use and psychiatric diagnoses
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ORIGINAL CONTRIBUTION
The combined self‑ and parent‑rated SDQ score profile predicts care use and psychiatric diagnoses Jorien Vugteveen1 · Annelies de Bildt2,3 · Catharina A. Hartman4 · Sijmen A. Reijneveld5,6 · Marieke E. Timmerman1 Received: 27 January 2020 / Accepted: 18 October 2020 © The Author(s) 2020
Abstract The Strengths and Difficulties Questionnaire (SDQ) is widely used, based on evidence of its value for screening. This evidence primarily regards the single informant total difficulties scale and separate difficulties subscales. We assessed to what degree adolescents’ SDQ profiles that combined all self- and parent-rated subscales were associated with use of care and psychiatric diagnoses, and examined the added value thereof over using only a single informant and the total scale. Cluster analysis was used to identify common SDQ profiles based on self- and parent-reports among adolescents aged 12–17 in mental healthcare (n = 4282), social care (n = 124), and the general population (n = 1293). We investigated associations of the profiles with ‘care use’ and ‘DSM-IV diagnoses’, depending on gender. We identified six common SDQ profiles: five profiles with varying types and severities of reported difficulties, pertaining to 95% of adolescents in care, and one without difficulties, pertaining to 55% of adolescents not in care. The types of reported difficulties in the profiles matched DSM-IV diagnoses for 88% of the diagnosed adolescents. The SDQ profiles were found to be more useful for predicting care use and diagnoses than SDQ scores reported by the adolescent as single informant and the total difficulties scale. The latter indicated the presence of problems among 42–63% of the adolescents in care, missing a substantial number of adolescents with reported emotional difficulties and borderline problem severity. These findings advocate the use of combined self- and parent-rated SDQ score profiles for screening. Keywords Adolescent mental health · Comorbidity · Multi-informant · Three-step multilevel mixture modelling
Introduction Approximately 15–25% of adolescents experience psychiatric problems [1, 2]. To receive adequate mental healthcare, these problems need to be effectively detected and diagnosed. To that end, it is recommended that clinicians Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-020-01667-5) contains supplementary material, which is available to authorized users. * Jorien Vugteveen [email protected] 1
consider information on the adolescent’s psychosocial functioning provided by multiple informants [3], for instance the adolescents themselves and their parents. Ratings from multiple informants are considered complementary, with more informants better reflecting differences in perspective [4–6]. One way to gather multiple-informant information for the purpose of screening for psychosocial problems is to ask the informants to complete a questionnaire, such as the widely used Strengths and Difficulties Questionnaire (SDQ)
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