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Identifying risk factors and detection strategies for adolescent depression in diverse global settings: A Delphi consensus study

Research output: Contribution to journalArticle

Syed Shabab Wahid, Katherine Ottman, Raya Hudhud, Kamal Gautam, Helen Fisher, Christian Kieling, Valeria Mondelli, Brandon A Kohrt

Original languageEnglish
Pages (from-to)66-74
Number of pages9
JournalJournal of Affective Disorders
Early online date1 Oct 2020
Publication statusE-pub ahead of print - 1 Oct 2020

King's Authors


Background: Adolescence represents a vulnerable period for the onset of depression. Globally, there is a need to better understand risk factors for adolescent depression to inform policies for effective prevention initiatives. Methods: A Delphi consensus study was conducted on risk factors, early signs, and detection strategies for adolescent depression in global settings. Over 3 survey rounds, global experts formulated and ranked these variables for (1) specificity for adolescent depression and (2) feasibility of measurement (round 1, n=21 participants; rounds 2 and 3, n=17). We calculated Smith's salience index as a measure of consensus. Interviews were conducted with 10 participants to elicit qualitative reflections on the ranking results, and on the influence of cultural and contextual factors on depression risks. Results: Thirty-one risk factors for adolescent depression were generated. Panelists ranked three as highly specific and highly feasible to measure: family history of depression, exposure to bullying, and a negative family environment. Six were ranked as modestly specific and highly feasible: physical illness or disability, female sex, bereavement, trauma exposure, substance abuse, and low self-esteem. An additional 5 items were modestly specific and modestly feasible: social difficulties, academic stress, poverty, loss of family, and cognitive distortions. Five symptoms were at least modestly specific and feasible to measure: mood changes, loss of interest, social isolation, suicidality, and sleep changes. Schools were considered the most feasible place for screening. Limitations: The participants were not representative of all countries and cultural regions. Conclusions: This study offers a profile of risk factors developed and prioritized by experts to inform a research agenda for risk, identification and prevention of adolescent depression across global settings.

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