Screening

Children and adolescents with risk factors seen at primary care settings need to be screened for depressive disorder.[59][60] Risk factors include:

  • Family history of mood disorder

  • History of trauma or recent trauma, including physical or sexual abuse or neglect

  • Significant psychosocial stress (e.g., parental divorce, parental depression, severe parental medical illness, loss of a loved one including pets, conflict in peer or romantic relationships, conflict with parents)

  • Poor performance in school

  • Significant change of functioning

  • Chronic or severe medical illness

  • Certain medication treatment (e.g., corticosteroids, interferon)

  • Recent history of giving birth.

Annual universal screening in a primary care setting is recommended for all children aged 12 years and older, even in the absence of specific risk factors, according to US-based guidance.[57] Children who come to a psychiatric facility always need to be screened for depression because depression is highly comorbid with other psychiatric disorders.

Screening should be completed by direct clinician interview, in addition to screening instruments.[57]

Reynolds adolescent/child depression scales (RADS/RCDS)

The RADS/RCDS[61][62] is a child- and parent-report depression instrument with useful psychometric properties. It is an effective screening tool but probably not a good instrument for monitoring treatment outcomes.[63] It is available in multiple languages and is suitable for both children and adolescents. It is copyrighted, and therefore must be purchased from the publisher.

Mood and feelings questionnaire (MFQ)

The MFQ is a self-, parent-, and teacher-reported depression scale for children and adolescents.[64] It is a good screening tool and can be used in both clinical and research settings.[65] It can be accessed online for clinical or research use. Duke University: Mood and Feelings Questionnaire external link opens in a new window A short version of the MFQ (MFQ-SF) was found to be sensitive in screening for major depressive disorder among youths aged 11-17 in a primary care setting.[66]

Beck depression inventory (BDI)

The BDI is a widely used adolescent self-rated depression scale with good psychometric properties.[67][63] It is copyrighted, so must be purchased from the publisher.

Child depression inventory (CDI)

The CDI is a 27-item, self-rated assessment of depression and/or dysthymic disorder symptoms.[68] Items are grouped into 5 factor areas. The CDI is a widely used and accepted assessment for the severity of depressive symptoms with high reliability.

Patient health questionnaire (PHQ-9): adolescents

The PHQ-9 is a psychological assessment for screening, diagnosing, and monitoring the severity of depression or dysthymic symptoms.[69] It is a brief self-report scale, and item 9 includes a screening question for suicidal ideation. Diagnostic validity has been established in primary care settings.

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