Grumpy or depressed? Disentangling normative irritability from early signs of depression among adolescents with cell-phone micro-measures of daily mood swings.

Rationale: Early signs of depression resemble prototypical behaviors of
teenagers, such as irritability, sadness, and grumpiness. Therefore, youths who
suffer from early depression are often not detected, and, therefore, receive
insufficient treatment. We hypothesize that adolescents at risk for depression
have an atypical rigid negative mood patterns across social contexts (e.g.,
school, home, peer group), that resembles the mood pattern of clinically
referred depressed youth and youth at risk for depression due to family load
(first degree family member affected). These mood patterns can be detected by
combining the methodological strengths of monitoring daily mood swings with
powerful cutting-edge Bayesian statistics.

Objective: We would like to differentiate *normative mood swings*. in
adolescence from early signs of depression. A comparison between low-risk
adolescents and an at risk and a clinically referred sample is needed to detect
an unrecognized subsample of adolescents at risk for depression among the
normal population.,

Study design: Adolescents will use a cell-phone app to monitor their mood over
the course of a week. State-of-the-art analyses will identify underlying mood
patterns and their unique predictive value for adolescent depression, compared
to multi-informant questionnaire data (i.e., adolescent and parent).

Nature and extent of the burden and risks associated with participation,
benefit and group relatedness: Adolescent participants are asked to fill in
questionnaires at the beginning of the study (total duration 30 min). The
ecological momentary assessment (EMA) period is 7 days with 8 measurements a
day. In total 56 measurements of 1 min during 7 days. Also parents are asked to
fill in a questionnaire about general functioning and parenting styles, mood
and behavior problems of their child (see schedule of measurements in method
section). Parents are also asked to give information about their own
psychological functioning.
EMA is a non-invasive technique, so there is no need for special preparation
for the subject. There are no known risks associated with the EMA and the data
are solely used for research purposes. Adolescents might benefit from this
study, by experiencing the effect of monitoring their mood and get insight in
their own mood profile.
If the results point out severe psychopathology (e.g. suicidality), the child
and adolescent psychiatrist involved (MH) will discuss the findings with the
treating psychiatrist of the participating adolescent.