Dantic, Dennis Emralino;
Jaya, Rebecca Sudhir;
Gafoor, Rafael;
Marston, Louise;
(2026)
Validated self-administered screening tools to identify depression among young adults (18 to 25-years-old) in East Asia and the Pacific Region low-and-middle income countries (LMICs): A systematic review.
Journal of Affective Disorders Reports
, 23
, Article 100999. 10.1016/j.jadr.2025.100999.
(In press).
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Abstract
This systematic review evaluates the validity, reliability, and diagnostic accuracy of self-administered screening tools for symptoms of depression among young adults (18 to 25 years old) in East Asia and the Pacific. A total of 22 studies with 24,069 participants were included, covering both clinical and non-clinical populations. Nine self-administered screening tools were identified, with Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-2 PHQ-2, and Centre for Epidemiological Studies Depression (CES-D) being the most frequently studied. PHQ-9 demonstrated moderate to excellent internal consistency reliability, with Cronbach’s alpha ranging from 0.67 to 0.92, and a pooled AUC of 0.86, indicating strong screening accuracy. PHQ-2, showed an Area Under the Curve (AUC) of 0.85, high sensitivity (0.96), and moderate specificity (0.80). CES-D exhibited an AUC of 0.87, good sensitivity (0.81), and specificity (0.78), with high heterogeneity (I² = 74.70 %–86.69 %). The meta-analysis revealed substantial variability in sensitivity and specificity across settings, with differences in study methodologies, cutoff scores, and reference standards contributing to high heterogeneity. Additionally, 95.5 % of studies had a moderate risk of bias in patient selection, affecting generalizability. Despite these limitations, PHQ-9, PHQ-2, and CES-D remain valuable tools for identifying symptoms of depression among young adults. The accessibility, ease of administration, and strong psychometric properties of these tests support their continued use in resource-limited settings, though standardization of methodologies and expanded regional validation are needed to improve screening accuracy and applicability.
| Type: | Article |
|---|---|
| Title: | Validated self-administered screening tools to identify depression among young adults (18 to 25-years-old) in East Asia and the Pacific Region low-and-middle income countries (LMICs): A systematic review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jadr.2025.100999 |
| Publisher version: | https://doi.org/10.1016/j.jadr.2025.100999 |
| Language: | English |
| Additional information: | /© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Screening tools, Self-administered tools, Depression, Young adults, Low- and middle-income countries (LMICs), Systematic review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > Comprehensive CTU at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217629 |
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