Clinical utility of the self-report Strengths and Difficulties Questionnaire (SDQ) in child and adolescent psychiatric outpatient setting.

Objectives. The aim of this study was to examine the prevalence of adolescent self-reported internalising and externalising difficulties in a clinical sample of adolescents seeking help in an outpatient psychiatric clinic and examine the clinical utility of the SDQ as a screening tool for predicting clinically determined mental health diagnoses.
Materials and Methods. The study was conducted at the Children’s Clinical University Hospital in Riga. The study group comprised 11-17 y.o. patients who received outpatient psychiatry care. SDQ self- report was used. It consists of emotional and peer problem subscales (combined – internalising difficulties), conduct and hyperactivity subscales (combined – externalising difficulties) and total difficulties scale. According to ICD-10, internalising disorders in this study were F3x, F4x, F50, F51, F93, externalising disorders included F1x, F90, F91, F92. When analysing the score, the Latvian community sample cut-off scores were used, 80th percentile was used for defining “high” score.
Results. 207 valid adolescent reports were analysed. Adolescents were mostly female (60.9%, N = 126), mean age 13.9 years. 58.9% had an internalising diagnosis, 23.2% an externalising diagnosis. In self-reports, 41.5% of adolescents reported high scores in internalising difficulties, and 27.1% reported high scores in externalising difficulties scale. High scores in emotional (r = 0.29, p < 0.0001), internalising (r = 0.29. p < 0.0001) and total difficulties (r = 0.21, p = 0.004) correlated positively with an internalising diagnosis, with sensitivity 50-66% and specificity 64-73%. A high score in the conduct subscale (r = 0.22, p = 0.002) correlated positively with an externalising diagnosis, with a sensitivity of 32% and a specificity 88%.
Conclusions. Emotional, internalising, and total difficulty scales showed a correlation with internalising clinical diagnoses, and conduct scale showed a correlation to externalising clinical diagnoses. Correlations were weak, and scale specificity was low. For the Latvian adolescent population, self-report SDQ may be better used to screen for internalising difficulties, and overall, both parent and adolescent reports should be used for more precise screening results.