Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review.
S A Cassidy, L Bradley, E Bowen and 2 others
PMID 29360200WHAT IT FOUND
No depression tool has been developed or validated for adults with autism spectrum conditions.
Only the BDI-II had measurement properties examined in this group, with weak or indeterminate evidence. The review does not show that standard tools accurately identify depression in this group.
Key findings
01No depression assessment tool used in adults with autism spectrum conditions had been developed or validated for that group.
02Only one study assessed measurement properties of a depression tool in adults with autism spectrum conditions, and it examined the BDI-II.
03In general population adults, the BDI-II and PHQ-9 showed adequate sensitivity and specificity for detecting clinical depression.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 12 studies used depression tools in adults with ASC, and only one study tested measurement properties in that group, so evidence for using tools with ASC is very limited. No tool had been developed or validated specifically for adults with ASC. The review searched only English-language articles published from 1992 to June 2016, so evidence in other languages or published after that date may be missing. Data extraction and COSMIN ratings were independently checked for only 20% of articles, and some subjectivity remains in rating measurement properties. No included study assessed measurement error or responsiveness to change, so the review cannot tell whether tools detect change over time or clinically meaningful change. The strict method excluded broader mental health tools that contain depression subscales, which may have overlooked other relevant data.
Declared interests
The supplied text does not include a conflicts of interest or funding declaration. The publication types note research support from non-U.S. government sources.
The easy way to misread this
Do not conclude that the BDI-II or PHQ-9 is validated for adults with ASC. The review found only one measurement-properties study in adults with ASC, and no depression tool had been developed or validated for that group.