Self-report vs. biological markers in assessment of childhood depression

Sensitivity, specificity, and diagnostic confidence of the Children's Depression Inventory (CDI) and the dexamethasone suppression test (DST) in assessing childhood depression were determined. Parent and child forms of the CDI and plasma cortisol levels at 8 a.m. and 4 p.m. were used. Three groups of prepubertal children were sampled: (1) 63 depressed inpatients, (2) 14 non-depressed inpatient psychiatric controls, and (3) 21 normal community sample controls. Results suggest that scores greater than or equal to 15 on the CDI obtained from either parent or child provide a good screening instrument (sensitivity = 89%). If the DST is administered to all children with elevated CDI scores, diagnostic confidence is 97.5%. Cautions and recommendations for use of the CDI and DST are made.