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Symptom screening scales for detecting major depressive disorder in children and adolescents: a systematic review and meta-analysis of reliability, validity and diagnostic utility.
journal contribution
posted on 2015-03-15, 00:00 authored by E Stockings, L Degenhardt, Yong Yi Lee, Cathy MihalopoulosCathy Mihalopoulos, A Liu, M Hobbs, G PattonBACKGROUND: 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.
History
Journal
Journal of Affective DisordersVolume
174Pagination
447 - 463Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
ISSN
1573-2517eISSN
1573-2517Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2015, ElsevierUsage metrics
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No categories selectedKeywords
Children and adolescentsDepressionPreventionPsychiatric Symptom Rating ScalesPsychometricsValidityScience & TechnologyLife Sciences & BiomedicineClinical NeurologyPsychiatryNeurosciences & NeurologyPSYCHOMETRIC PROPERTIESRATING-SCALESMENTAL-HEALTHINVENTORY-IIYOUNG-PEOPLEPRIMARY-CARECES-DPSYCHIATRIC-DISORDERSDISCRIMINANT VALIDITYNEGATIVE AFFECTIVITY
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