Assessment of depression in medically ill children presenting to pediatric specialty clinics.
OBJECTIVE
Self-report measures of depression may be inaccurate when applied to medically ill children because of the overlap between medical and psychiatric symptoms. The American Academy of Pediatrics endorses the use of self-reports as diagnostic aids (used in patients who are suspected of having an emotional problem by their pediatricians). This approach has not been validated. We evaluated the diagnostic accuracy of the Children's Depression Inventory (CDI) in medically ill children who were referred for evaluation by their pediatricians.


METHODS
The evaluation included the CDI and a best estimate diagnostic procedure that incorporated results from semistructured and other interviews. Evaluators were not aware of the CDI scores when making a diagnostic determination.


RESULTS
One hundred twenty-five patients, 8-19 years old, were referred between September 2000 and May 2003. Eighty-one completed the diagnostic procedure. The CDI summary score performed well in identifying best estimate depressive disorder determinations in this cohort. A cutoff of 11 and above correctly identified 80% of cases, with a specificity of 70%.


CONCLUSIONS
A self-report measure of depression (CDI) could be used as a diagnostic aid in medically ill children who are suspected of having an emotional problem by their pediatricians. This finding supports the "two-tier" depression screening approach endorsed by the American Academy of Pediatrics for use in pediatricians' offices.
Shemesh
Eyal
E
Department of Psychiatry, Division of Child and Adolescent Psychiatry, NY 10029, USA. eyal.shemesh@mssm.edu
Yehuda
Rachel
R
Rockmore
Lori
L
Shneider
Benjamin L
BL
Emre
Sukru
S
Bartell
Abraham S
AS
Schmeidler
James
J
Annunziato
Rachel A
RA
Stuber
Margaret L
ML
Newcorn
Jeffrey H
JH
D000293:Adolescent; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008511:Medicine; D009519:New York City; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012803:Sick Role; D013038:Specialization