Development of a Risk Warning Indicator System for Depression in Children and Adolescents

Abstract

The objective of the study was to create a risk warning indicator system specifically aimed at detecting depression in children and adolescents, facilitating early and precise identification. To establish a preliminary framework for these indicators, the researchers conducted a comprehensive literature review and engaged in expert meetings. The Delphi method was utilized over two rounds of consultations, which helped screen and enhance the proposed indicators. The research team engaged in multiple discussions to refine the outcomes of these consultations, eventually identifying crucial warning indicators. The study evaluated the developed indicators on a cohort of 386 outpatient children and adolescents diagnosed with depression to assess their reliability. Expert response rates in both Delphi rounds were recorded at 100%, with authority coefficients measuring 0.808 and 0.868, respectively. Furthermore, Kendall’s coefficient of concordance for the two rounds indicated values of 0.131 and 0.142, both statistically significant (P < 0.001). The finalized risk warning indicator system included five primary indicators and 38 secondary indicators, meeting stringent criteria for effectiveness: a mean importance rating exceeding 3.5, a coefficient of variation below 0.25, and a full-score ratio above 20%. Notably, the content validity index (CVI) for individual items ranged from 0.881 to 1.000, yielding an average CVI of 0.995, while the universal agreement CVI stood at 0.832. The overall reliability of the indicators was substantiated by a KR-20 coefficient of 0.811 and a split-half reliability coefficient of 0.745. In conclusion, the risk warning indicator system developed in this research exhibits robust scientific validity, practicality, and innovative potential, making it a valuable tool for clinical application and broader dissemination in the field of pediatric mental health.