Utility of the Child Behavior Checklist in screening depressive disorders within clinical samples

Previous studies analyzed the clinical validity of the Child Behavior Checklist (CBCL) for screening primary depressive disorders (major depression and dysthymia). Other psychiatric disorders with depressive symptomatology (e.g. adjustment disorders with depressive reaction) have not been a research focus to date. This study aims to examine the utility of the CBCL scales Anxious/Depressed and Affective Problems in screening both primary depressive disorders and other disorders with depressive symptomatology.

The two samples consisted of 1445 outpatients and 698 inpatients aged 11-18 who were referred for child and adolescent psychiatric services. The predictive power of the CBCL scales was examined using ROC-analysis.

Both CBCL scales showed small to medium predictive power when screening for primary and other depressive disorders in clinically referred outpatients (AUCs=.694-.780). Within the inpatient sample, only primary depressive disorders were detected with small predictive power different from chance level (AUCs=.625-.673). Both CBCL scales did not differ significantly with regards to predicting depressive disorders.

A limitation of this study is the lack of reliability checks for consensus classification process of the ICD-10 diagnoses. However, comparable prior work using structured interviews resulted in similar AUC values, supporting our findings.

In outpatient samples, the CBCL is suitable for screening other depressive disorders in addition to primary depressive disorders. This is not the case for inpatients due to a misclassification number of 40%; thus using CBCL scales screen for depressive disorders in such populations warrants caution.