title: Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscale for Identifying Youth Mood Disorders.
abstract: This study examined the diagnostic and clinical utility of the Child and Adolescent Symptom Inventory-4 R (CASI-4 R) Depressive and Dysthymia subscale for detecting mood disorders in youth (ages 6-12; M = 9.37) visiting outpatient mental health clinics. Secondary analyses (N = 700) utilized baseline data from the Longitudinal Assessment of Manic Symptoms study. Semistructured interviews with youth participants and their parents/caregivers determined psychiatric diagnoses. Caregivers and teachers completed the CASI-4 R. CASI-4 R depressive symptom severity and symptom count scores each predicted mood disorder diagnoses. Both caregiver scores (symptom severity and symptom count) of the CASI-4 R subscale significantly identified youth mood disorders (areas under the curve [AUCs] = .78-.79, ps < .001). The symptom severity version showed a small but significant advantage. Teacher symptom severity report did not significantly predict mood disorder diagnosis (AUC = .56, p > .05), whereas the teacher symptom count report corresponded to a small effect size (AUC = .61, p < .05). The CASI-4 R Depression scale showed strong incrememental validity even controlling for the other CASI-4 R scales. Caregiver subscale cutoff scores were calculated to assist in ruling in (diagnostic likelihood ratio [DLR] = 3.73) or ruling out (DLR = 0.18) presence of a mood disorder. The CASI-4 R Depressive subscale caregiver report can help identify youth mood disorders, and using DLRs may help improve diagnostic accuracy.
authors.affiliation: b Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Salcedo
authors.affiliation: a Department of Psychology, University of Nevada, Las Vegas.
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chen
authors.affiliation: b Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.affiliation: c Department of Psychiatry, Ohio State University.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
authors.affiliation: d Department of Psychiatry , Stony Brook University.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Gadow
authors.affiliation: e Department of Child and Adolescent Psychiatry, NYU Langone Medical Center.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Horwitz
authors.affiliation: f Pediatric Institute, Cleveland Clinic.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.affiliation: c Department of Psychiatry, Ohio State University.
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.affiliation: g Department of Psychiatry, University of Pittsburgh.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Phillips
authors.affiliation: g Department of Psychiatry, University of Pittsburgh.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: h Department of Psychiatry, Ohio State University Medical Center and Nationwide Children's Hospital.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kowatch
authors.affiliation: i Department of Psychiatry and Behavioral Sciences, Johns Hopkins University and Kennedy Krieger Institute.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology; D002648:Child; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results