Who should we ask about mental health symptoms in adolescents with CFS/ME? Parent-child agreement on the Revised Children’s Anxiety and Depression Scale

Teona Serafimova, Maria Loades, Daisy Gaunt, Esther Crawley

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Abstract

Background:

One in three adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have mental health problems. Multi-informant perspectives are key to psychological assessment. Understanding parent-child agreement is crucial to accurate diagnosis, particularly where severe fatigue limits self-report.
Methods:

Agreement on the revised children’s anxiety and depression scale (RCADs) was assessed between parents and children with CFS/ME (n = 93) using Bland-Altman plots, cross tabulations and regression analyses.
Results:

Diagnostic thresholds were met more frequently based on child-report. Parent- and child-report had similar sensitivity and specificity on RCADS compared to gold-standard diagnostic interviews. Regression analysis found similar accuracy between both reports. For anxiety diagnoses, odds ratio (OR) for child-report was 1.10 (CI = 1.06–1.14), and 1.10 (CI = 1.05–1.14) for parent-report. For depression, OR for child report was 1.26 (CI = 1.11–1.43), while for parent-report is was 1.25 (CI = 1.10–1.41). For total score, OR for child-report was 1.10 (CI = 1.05–1.13) while OR for parent-report was 1.09 (CI = 1.05–1.13).
Conclusions:

Reasonable agreement was observed between parent- and child-report of mental health symptoms in paediatric CFS/ME. While parent-report can facilitate psychological evaluation in CFS/ME, this is not a substitute for a child’s own report.
Original languageEnglish
Pages (from-to)367-380
JournalClinical Child Psychology and Psychiatry
Volume26
Issue number2
Early online date15 Feb 2021
DOIs
Publication statusPublished - 30 Apr 2021

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