TY - JOUR
T1 - Symptom screening scales for detecting major depressive disorder in children and adolescents
T2 - A systematic review and meta-analysis of reliability, validity and diagnostic utility
AU - Stockings, Emily
AU - Degenhardt, Louisa
AU - Lee, Yong Yi
AU - Mihalopoulos, Cathrine
AU - Liu, Angus
AU - Hobbs, Megan
AU - Patton, George
N1 - Funding Information:
The work was funded by the National Health and Medical Research Council of Australia , Centre of Research Excellence in Mental Health Systems Improvement (CREMSI) (NH&MRC Grant no. APP1041131 ).
Publisher Copyright:
© 2014 Elsevier B.V. All rights reserved.
PY - 2015/3/15
Y1 - 2015/3/15
N2 - Background Depression symptom screening scales are often used to determine a clinical diagnosis of major depressive disorder (MDD) in prevention research. The aim of this review is to systematically examine the reliability, validity and diagnostic utility of commonly used screening scales in depression prevention research among children and adolescents.Methods We conducted a systematic review of the electronic databases PsycINFO, PsycEXTRA and Medline examining the reliability, validity and diagnostic utility of four commonly used depression symptom rating scales among children and adolescents: the Children's Depression Inventory (CDI), Beck Depression Inventory (BDI), Center for Epidemiologic Studies - Depression Scale (CES-D) and the Reynolds Adolescent Depression Scale (RADS). We used univariate and bivariate random effects models to pool data and conducted metaregression to identify and explain causes of heterogeneity.Results We identified 54 studies (66 data points, 34,542 participants). Across the four scales, internal reliability was 'good' (pooled estimate: 0.89, 95% Confidence Interval (CI): 0.86-0.92). Sensitivity and specificity were 'moderate' (sensitivity: 0.80, 95% CI: 0.76-0.84; specificity: 0.78, 95% CI: 0.74-0.83). For studies that used a diagnostic interview to determine a diagnosis of MDD, positive predictive power for identifying true cases was mostly poor. Psychometric properties did not differ on the basis of study quality, sample type (clinical vs. nonclinical) or sample age (child vs. adolescent).Limitations Some analyses may have been underpowered to identify conditions in which test performance may vary, due to low numbers of studies with adequate data.Conclusions Commonly used depression symptom rating scales are reliable measures of depressive symptoms among adolescents; however, using cutoff scores to indicate clinical levels of depression may result in many false positives.
AB - Background Depression symptom screening scales are often used to determine a clinical diagnosis of major depressive disorder (MDD) in prevention research. The aim of this review is to systematically examine the reliability, validity and diagnostic utility of commonly used screening scales in depression prevention research among children and adolescents.Methods We conducted a systematic review of the electronic databases PsycINFO, PsycEXTRA and Medline examining the reliability, validity and diagnostic utility of four commonly used depression symptom rating scales among children and adolescents: the Children's Depression Inventory (CDI), Beck Depression Inventory (BDI), Center for Epidemiologic Studies - Depression Scale (CES-D) and the Reynolds Adolescent Depression Scale (RADS). We used univariate and bivariate random effects models to pool data and conducted metaregression to identify and explain causes of heterogeneity.Results We identified 54 studies (66 data points, 34,542 participants). Across the four scales, internal reliability was 'good' (pooled estimate: 0.89, 95% Confidence Interval (CI): 0.86-0.92). Sensitivity and specificity were 'moderate' (sensitivity: 0.80, 95% CI: 0.76-0.84; specificity: 0.78, 95% CI: 0.74-0.83). For studies that used a diagnostic interview to determine a diagnosis of MDD, positive predictive power for identifying true cases was mostly poor. Psychometric properties did not differ on the basis of study quality, sample type (clinical vs. nonclinical) or sample age (child vs. adolescent).Limitations Some analyses may have been underpowered to identify conditions in which test performance may vary, due to low numbers of studies with adequate data.Conclusions Commonly used depression symptom rating scales are reliable measures of depressive symptoms among adolescents; however, using cutoff scores to indicate clinical levels of depression may result in many false positives.
KW - Children and adolescents
KW - Depression
KW - Prevention
KW - Psychiatric Symptom Rating Scales
KW - Psychometrics
KW - Validity
UR - http://www.scopus.com/inward/record.url?scp=84920112124&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2014.11.061
DO - 10.1016/j.jad.2014.11.061
M3 - Review Article
C2 - 25553406
AN - SCOPUS:84920112124
SN - 0165-0327
VL - 174
SP - 447
EP - 463
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
