Norms and screening utility of the Dutch version of the Children's Depression Inventory in clinical and nonclinical youths.

Abstract

This study aimed to (1) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report (YSR); (2) develop reliable norms for the CDI; and (3) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3073 non-clinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to both DSM-oriented symptoms of depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the YSR were determined by means of multiple regression analysis and ROC analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. It can be concluded that the CDI is an effective instrument for screening depression, and to a lesser extent anxiety, in school settings or primary and secondary care centres, before applying further assessment of high risk individuals. Keywords: CDI; Children's Depression Inventory; Cutoff; NormingThe CDI in clinical and non-clinical youth 3 Depressive symptoms are commonly experienced among youth. The epidemiological data suggest that depression in youth is a serious health care problem, which underscores the importance of using reliable and well-validated screening instruments (e.g., Birmaher et al., 1996; Birmaher, Arbelaez, & Brent 2002; Lewinsohn, Rohde, & Seeley, 1998). The measurement of depressive symptoms in youth was advanced by the development of the Children's Depression Inventory (CDI: Kovacs, 1980Kovacs, /1981. The CDI was developed as a downward extension of the adult-oriented Beck Depression Inventory (BDI: Beck, Ward, Mendelson, Mock & Erbaugh, 1961). The CDI is a 27-item self-report inventory assessing depressed mood in children and adolescents. Respondents are asked to choose one of three descriptions that best fits how they have been feeling over the past two weeks (e.g., "I do most things wrong", "I do many things wrong", "I do everything wrong"). Responses are scored on a scale from 0 to 2, with total CDI scores ranging between 0 and 54. Although the CDI is designed to provide information about the presence and severity of depressive symptoms, it cannot by itself yield a psychiatric diagnosis. Self-report measures in the early assessment process have however also the advantage over clinical interviews that they facilitate disclosing personal material. The current study aimed to (1) assess the specificity of the relation between CDI scores and symptoms of depression and anxiety; (2) develop no...

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Adequate Screening of Youngsters for Depressive Characteristics

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