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Is the Children's Depression Inventory Short version a valid screening tool in pediatric care? A comparison to its
Antje-Kathrin Allgaier1, Barbara Frühe, Kathrin Pietsch
1Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-University Munich, and Department of Paediatrics, Hospital Dritter Orden, Germany. antje.allgaier@med.uni-muenchen.de
Insights
The Children's Depression Inventory (CDI) and its short version (CDI:S) effectively screen for depression in medically ill children. The brief CDI:S is highly sensitive but requires further diagnostic assessment to confirm results.
Area of Science:
- Child and Adolescent Psychiatry
- Pediatric Psychology
- Mental Health Screening
Background:
- Depression is a significant concern in medically ill children.
- Accurate screening tools are crucial for early identification and intervention.
- The Children's Depression Inventory (CDI) and its short version (CDI:S) are potential screening instruments.
Purpose of the Study:
- To validate and compare the Children's Depression Inventory (CDI) and its short version (CDI:S).
- To assess their utility as screening tools for depression in medically ill pediatric patients.
Main Methods:
- 406 pediatric patients (ages 9-12) completed the German CDI.
- Criterion validity was assessed using receiver operating characteristic (ROC) curves.
- DSM-IV depression diagnoses (via Kinder-DIPS) served as the reference standard.
Main Results:
- Depression diagnoses were present in 7.4% of children.
- Areas under the ROC curves for CDI (87.7%) and CDI:S (88.2%) were comparable.
- CDI:S showed high sensitivity (93.3%) but lower specificity (70.7%) compared to CDI.
Conclusions:
- Both CDI and CDI:S are valid for screening depression in medically ill children.
- The brief and sensitive CDI:S is suitable for time-constrained pediatric settings.
- Follow-up diagnostic assessment is necessary for CDI:S to manage false positives.
Objective:
This is the first study to validate and to compare the Children's Depression Inventory (CDI) and its short version (CDI:S) as screening tools for medically ill children.
Methods:
A sample of 406 pediatric hospital patients, aged 9 to 12 years (56.2% male, 77.1% inpatients), completed the German CDI. Criterion validity of the 26-item CDI and the 10-item CDI:S was calculated by receiver operating characteristic (ROC) curves. DSM-IV diagnoses of depression based on the structured diagnostic interview for mental disorders in children and adolescents (Kinder-DIPS) served as the reference standard. Areas under the ROC curves as well as sensitivities and specificities for the optimal cutoffs were compared for both versions.
Results:
Diagnoses of major or minor depression were established for 7.4% of the children. Areas under the curve for the 26-item CDI (87.7%) and the 10-item CDI:S (88.2%) were comparable. For the CDI, the cutoff≥12 yielded the best balance between sensitivity (83.3%) and specificity (82.7%). At the optimal cutoff≥3, the CDI:S resulted in a high sensitivity of 93.3% and a specificity of 70.7%. Thus, the CDI:S proved to be as sensitive as the CDI, but was less specific than the full-length version.
Conclusion:
Both the CDI and the CDI:S are valid screening instruments for depression in medically ill children. The sensitive and brief CDI:S is a promising tool in time-pressed settings such as pediatric care, but has to be followed by a thorough diagnostic assessment to rule out false positive cases.
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