title: Validation of the children's depression rating scale- revised for adolescents in primary-care pediatric use in India.
abstract: BACKGROUND
  Adolescent depression needs to be identified and treated in the primary care settings. There is no clinician-rated measure validated in India for identifying depression among adolescents.
  
  
  OBJECTIVE
  We studied the diagnostic accuracy, reliability, and validity of Children's Depression Rating Scale - Revised (CDRS-R) for primary care pediatrics.
  
  
  METHODS
  Prospective study in three schools in Southern India.
  
  
  METHODS
  Adolescents recruited were administered the CDRS-R by a pediatrician and clinical psychologist along with Beck Depression Inventory (BDI) for convergent validity. Impact of Event Scale (IES) for divergent validity and the ICD-10 clinical diagnosis of depressive disorders using modified Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) interview as reference standard were administered by a psychiatrist independently. Appropriate statistical analyses for diagnostic accuracy, reliability, and validity were done.
  
  
  RESULTS
  A cut-off score of 30 (sensitivity = 83%, specificity = 84%; AUC in ROC = 87%) in CDRS-R is suggested for diagnosing depression. The inter-rater reliability (r = 0.73) and test-retest reliability (r = 0.98) was good. In addition to the adequate face and content validity, CDRS-R had good internal consistency (α = 0.76), high convergent (r = 0.71; P = 0.001), and divergent validity (r = 0.28; P = 0.20). There was moderate concordance with the reference standard of ICD-10 diagnosis (45.5%) in identifying depression and CDRS-R discriminated 80% of the other psychiatric morbidity. The six-factor structure explained 60.6% of variance.
  
  
  CONCLUSIONS
  The CDRS-R showed strong psychometric properties and is now available for use in the primary-care pediatric practice in India.
authors.affiliation: Department of Psychiatry, Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mona M
authors.initials: MM
authors.lastname: Basker
authors.forename: Paul Swamidhas Sudhakar
authors.initials: PS
authors.lastname: Russell
authors.forename: Sushila
authors.initials: S
authors.lastname: Russell
authors.forename: Prabhakar D
authors.initials: PD
authors.lastname: Moses
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D015203:Reproducibility of Results