A new way to identify teenagers who are at high risk for depression
Using sociodemographic information alone, the model had limited success in predicting which youth would develop depression later. But when biomarkers were included, the prediction became much stronger. The difference in results was amazing. None of the young people identified as low risk on both criteria developed depression in the following three years, while almost half (44%) of those identified as high risk on both criteria did. Those who were most at risk on one scale fell somewhere in between, showing that combining life circumstances with biological information gives a much clearer picture of who might need support. Published today (Monday 2 March) in Molecular Psychiatry.
“This is the first time we have been able to show that combining biological markers with social and environmental factors can meaningfully improve the prediction of adolescent depression,” said Dr Zuzanna ZajkowskaResearch Associate, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience and lead author from King’s College London.
“It brings us closer to an effective screening tool that can help implement targeted and effective prevention strategies before symptoms begin.”
The new integrated test method, called IDEA‑BIO‑RS includes:
- Four markers in the blood are linked to inflammation
- Kynurevnic acid/quinolinic acid ratio (KA/QA) – a measure of how well the brain balances defenses against harmful chemical processes
- Brain activity in an area (amygdala) involved in processing emotional experiences such as sadness, fear or anger. These biomarkers reflect processes known to be vulnerable to depression, including inflammation, emotional sensitivity to negative emotions, and biochemical pathways linked to stress.
Which can have a global impact
The study setting was intentionally designed to be universal, with blood-based markers providing a more universally applicable option compared to neuroimaging. The authors suggest a step-by-step screening approach, starting with the low-cost IDEA‑RS, and then applying a biological score to youth flagged as high risk.
“The majority of young people who develop depression have never received mental health support,”
Said the Professor Valeria Mondellisenior author, joint leader of the Psychosis and Mood Disorders Theme at the NIHR Maudsley Biomedical Research Center and Professor of Psychoneuroimmunology at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London. “A tool like this could revolutionize defense strategies around the world, especially in low resource settings where demand is greatest. A slow screening approach can provide a pragmatic solution, where cheap, accessible indicators are used initially, and resource-intensive biological tests are reserved for high-risk populations. Blood-based biomarkers appear to be feasible given their established functionality and low cost”he adds.
The researchers emphasize the need to validate the IDEA‑BIO‑RS in larger and more diverse populations and examine how biological markers may function differently across genders and social contexts.
If confirmed, this combined biological–sociodemographic approach could form the basis of the first clinically applicable assessment method for depression risk in youth.
The Identifying Depression Early in Adolescence (IDEA) project is a global initiative involving researchers on all five continents, which aims to revolutionize the early detection and prevention of adolescent depression.
The researchers are very grateful to the schools and people who participated in this study.
