Symptom screening scales for detecting major depressive disorder in children and adolescents: A systematic review and meta-analysis of reliability, validity and diagnostic utility

Author(s)
Stockings, Emily
Degenhardt, Louisa
Lee, Yong Yi
Mihalopoulos, Cathrine
Liu, Angus
Hobbs, Megan
Patton, George
Publication Date
2015-03-15
Abstract
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.
Citation
Journal of Affective Disorders, v.174, p. 447-463
ISSN
1573-2517
0165-0327
Pubmed ID
25553406
Link
Language
en
Publisher
Elsevier BV
Title
Symptom screening scales for detecting major depressive disorder in children and adolescents: A systematic review and meta-analysis of reliability, validity and diagnostic utility
Type of document
Journal Article
Entity Type
Publication

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