Cut-Off Scores of the Children's Depression Inventory for Screening and Rating Severity in Korean Adolescents

OBJECTIVE: The aim was to establish an optimal cut-off score of the Children's Depression Inventory (CDI) for detecting depression and rating severity in Korean adolescents. METHODS: A total of 468 students aged 12-16 years from 8 middle schools in Busan, Korea participated in this study. The Korean version of the CDI and Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version were used to evaluate depressive symptoms. Receiver-operating characteristics (ROC) analyses were conducted to evaluate case-finding performance and set the cut-off scores. RESULTS: ROC analyses demonstrated that the overall discrimination power of the CDI is good enough to evaluate adolescent depression. The CDI sum score of 20 was identified as the optimal screening cut-off score, where sensitivity was 0.83 and specificity was 0.89. This cut-off score could apply regardless of subjects' gender. The cut-off scores were examined in order of the depression severity: 15 for mild, 20 for moderate, and 25 for severe depression with high sensitivity and specificity. CONCLUSION: The CDI cut-off scores of our study can be recommended for screening depressed youth and rating the severity of depressive symptoms. The high negative predictive value suggested that the cut-off score of 20 would result in a small number of missed cases. Further studies are needed to ascertain these CDI cut-off scores for different age groups.

Indicadores psicométricos do Inventário de Depressão Infantil em amostra infanto-juvenil / Psychometric Indicators of Children's Depression Inventory and Childhood Sample / Indicadores Psicométricos del Inventario de Depresión Infantil en una Muestra Infanto-Juvenil

Este estudo verificou aspectos de validade, fidedignidade e normatização do Inventário de Depressão Infantil (CDI) numa amostra da população de crianças e adolescentes da cidade de Teresina - PI. Participaram do estudo 730 escolares, entre 9 e 17 anos (M=13,6; DP=2,45), 55,7% do sexo feminino. Efetuou-se uma análise fatorial com o método Maximum Likelihood - ML e os resultados indicaram uma solução unifatorial, composta por 17 itens. Esta estrutura explicou 22,56% da variância total, com índice de consistência interna α=0,82 (alfa de Cronbach). Sugere-se o ponto de corte 16 como screening na identificação dessa alteração psicoafetiva. Os resultados revelaram que o instrumento possui parâmetros psicométricos aceitáveis para a estrutura unifatorial mantida e reforçam sua validade e utilidade na identificação de sintomas depressivos no contexto infanto-juvenil...

This study aimed for the verification of validity, fidedignity and normalization aspects of the Children's Depression Inventory (CDI) for a children and teenagers population sample in the city of Teresina, PI. Seven hundred and thirty scholars participated in the study with ages ranging from nine to seventeen (M=13.6; DP=2.45), being 55.7% female. It was made a factor analysis based on the Maximum Likelihooh method - ML and the results indicated anunifactor solution, consisted by seventeen items. The structure explained 22.56% of total variance, with a internal consistency indicator of α=0.82 (Cronbach’s alpha). It is suggested a cut-off point of sixteen to be used as screening in the identification of these psychoaffective changes. Results revealed the instrument possess acceptable psychometric parameters to the unifactor structure kept and reinforce its validity and utility in the identification of depressive symptoms in the juvenille context...

En este estudio, el objetivo ha sido la verificación de aspectos de eficacia, fidedigno y estándar del Inventario de la Depresión Infantil (CDI) para una muestra de población de niños y adolescentes de Teresina - PI. Participaron en el estudio 730 alumnos, con edades entre 9 y 17 años (M=13,6; DP=2,45), siendo el 55,7% del sexo femenino. Se ha efectuado un análisis factorial a partir del método Maximum Likelihood - ML y los resultados indicaron una solución unifactorial, compuesta por 17 ítems. Esta estructura determinó un 22,56% de la variancia total, con un índice de consistencia interna α=0,82 (alfa de Cronbach). La sugerencia de este estudio proporciona un punto de corte 16 para ser utilizado como screening en la identificación de esta alteración psicoafectiva. Los resultados apuntan parámetros psicométricos aceptables para la estructura factorial mantenida y refuerzan su eficacia y utilidad en la identificación de los síntomas depresivos en el contexto infanto-juvenil...

Aspectos neuropsicológicos asociados a la presencia de síntomas depresivos en niños escolarizados / Neuropsychological aspects associated with depressive symptoms in school children / Aspectos neuropsicológicos associados à presença de sintomas depressivos em crianças escolarizadas

El propósito del estudio fue estimar la presencia de sintomatología depresiva en una muestra no clínica de niños escolarizados y describir el funcionamiento neuropsicológico de niños con sintomatología depresiva para compararlo con un grupo de características demográficas similares sin sintomatología depresiva. Para tal fin se aplicó el Inventario para la depresión infantil (Children Depression Inventory, CDI) a 312 niños escolarizados entre 9 y 12 años. Con base en los resultados se seleccionaron 62 niños los cuales se distribuyeron en dos grupos: uno con sintomatología depresiva y otro sin síntomas. La evaluación neuropsicológica incluyó: Test de caras, Cancelación de la A, Test de trazados (TMT) A y B, Figura de Rey, Stroop y Test de aprendizaje verbal para niños (CVLT). El CDI mostró que el 13.78% de los niños presenta sintomatología depresiva. La evaluación neuropsicológica arrojó únicamente diferencias significativas en la tarea de conflicto del Stroop. Esto sugiere que a nivel subclínico está afectada la capacidad para inhibir respuestas automáticas.

The purpose of this study was to estimate the presence of depressive symptoms in a nonclinical sample of school children and describe the neuropsychological functioning of children with depressive symptoms to compare them with a similar demographic group without depressive symptoms. To this end the Child Depression Inventory (Children Depression Inventory, CDI) was administered to 312 school children aged between 9 and 12. Based on the results 62 children were selected and distributed into two groups: one with depressive symptoms and one without symptoms. Neuropsychological assessment included: the Perceptions and Differences Test -FACES, the Cancelación de la A [A Cancellation Test], the Trail Making Test (TMT) forms A and B, the Rey Figure Test, the Stroop Test and the California Verbal Learning Test for Children (CVLT). The CDI showed that 13.78% of children have symptoms of depression. Neuropsychological assessment showed only significant differences in the conflict task of the Stroop Test. This suggests that the ability to inhibit automatic responses is affected at a subclinical level.

O propósito do estudo foi estimar a presença de sintomatologia depressiva em una mostra não clínica de crianças escolarizadas e descrever o funcionamento neuropsicológico de crianças com sintomatologia depressiva para compará-lo com um grupo de características demográficas similares sem sintomatologia depressiva. Para tal fim aplicou-se o Inventário para a depressão infantil (Children Depression Inventory, CDI) a 312 crianças escolarizados entre 9 e 12 anos. Com base nos resultados foram selecionadas 62 crianças, que foram distribuídas em dois grupos: um com sintomatologia depressiva e outro sem sintomas. A avaliação neuropsicológica incluiu: Teste de caras, Cancelamento do A, Teste de traçados (TMT) A e B, Figura de Rei, Stroop e Teste de aprendizagem verbal para crianças (CVLT). O CDI mostrou que 13.78% das crianças apresenta sintomatologia depressiva. A avaliação neuropsicológica mostrou diferenças significativas somente na tarefa de conflito do Stroop. Isto sugere que a nível subclínico está afetada a capacidade para inibir respostas automáticas.

Difference between Children's Self-Reports on Depression and Parents' Assessment of Children's Behaviors

OBJECTIVES: Childhood is a critical period involving various developmental tasks that need to be accomplished. Childhood depression has overall negative implications for certain areas of development, including cognition, emotion, social skills, academic achievement, and ability to cope with stress. Yet, because depression can be "masked" by accompanying behavioral problems, early detection and diagnosis of childhood depression is somewhat challenging. In this study, using the Korean version of the Child Behavior Checklist (K-CBCL), we evaluated the association between children's self reports on depression and parents' assessment of children's behaviors. METHODS: Subjects were recruited from the S city, a cohort comprising a non-random convenience sample of 226, 10-year-old ethnic Koreans in their fourth year of elementary school and their parents. All participants underwent several tests, including Children's Depression Inventory (CDI) and K-CBCL. RESULTS: A total of 226 children, including 166 boys (73.5%) and 60 girls (26.5%), participated in the study. The average CDI for the participants was 14.57 (SD=7.54). Two items on the K-CBCL, total scale of adjustment scale and social withdrawal problems, showed a close association with the CDI. CONCLUSION: Although much remains to be elucidated, after controlling for covariates, the results of this study suggested that behavioral problems observed in children may be closely associated with depression.

Depression and Coping Strategies Among Sexually Abused Children In A Malay Community In Malaysia

Objective: The fact that childhood sexual abuse is associated with depression is well-known. To date, there is no proper study done on screening for depression and coping strategies among sexually abused children in Malaysia. This study aimed to determine the prevalence of depression and examine the association of depression with the socio-demographics and coping strategies used by sexually abused children. Methods: Sixty-five sexually abused children who attended the One Stop Crisis Centre (OSCC) services at Hospital Universiti Sains Malaysia and fulfilled the study criteria were screened for depression using a validated Malay version of Children Depression Inventory (CDI).Depression was determined by a positive score of the Malay-CDI with depression being indicated in scores of more than 18. Results: In the study sample, 16 (24.6 %) participants had been depressed and 49 (75.4 %) participants had not been depressed. Having a confidante was a protective factor against depression. Short duration of time between the abuse incident and the clinical interview was significantly associated with depression. With respect to coping strategies, 59 (90.8 %) used emotion-focused strategies and 6 (9.2 %) used problem or task-focused strategies. Among emotion-focused coping strategies, participants did the following: deciding that nothing could be done to change things, were in denial, and suppressed their feelings. Conclusion: Twenty five percent of the sample suffered from depression. The screening of depression in the vulnerable group such as sexually abused children is important, particularly for early detection and treatment. By recognizing the coping strategies used in sexually abused children, the clinician could understand them better and plan for their psychological management.

Interpersonal and Environmental Factors that Predict Depression in Lower Secondary School Girls

Objective: Numerous studies indicate that interpersonal and environmental factors have a role in creating depressive symptoms in children. The objective of the study was to find out how temperament, negative life events, locus of control and social support predicted children's depression. Method: In this study, 243 female secondary school students were surveyed to ascertain how these factors predicted depressive symptoms. Results: The results of the analysis yield several conclusions. First, that not all aspects of temperament predict depression, the strongest seems to be mood. Second, that how upset a child is with negative events is a stronger predictor of depression compared with the total number of negative events. Third, locus of control predicts depression and fourth, social support from friends and parents also predicts depression. Conclusion: However when all the above factors are taken in to account, locus of control, extent of upsetness with the events and social support from friends are stronger predictors, relative to the other factors.

The propensity to depression and anxiety in children

BACKGROUND: The goals of this study are to investigate the propensity to depression and anxiety in children, and also, to investigate its relationship to the family structure, their life events, and school achievement. We have attempted to aid the continuous and comprehensive management of children with depression and anxiety in a field of family practice. METHODS: A group of 797 boys and girls in 5th and 6th were selected grades a elementary school in their, In the area of ll-san and In-cheon city in August, 1997. Making use of the Kovacs' Children's Depression Inventory(CDI, 1977) and the Spielberger's State-Trait Anxiety Inventory for Children(STAIC, 1973), we investigated the propensity to depression and anxiety by self-rating. At the same time, the general characteristics(gender, age, resideuce, family structure), life events(death single parent, divorced family, death of a sibling, family discord between husband), and school achievement were investigated and assessed their relationship. RESULTS: The Children's Depression Inventory score was 11.69, the State Anxiety Inventory score was 31.51, and the Trait Anxiety Inventory score was 31.49. The CDI score were significantly higher in females, sixth year students, residents execpt for those living in an apartment or villa, and low school achievement group(P<0.01, P<0.05), There was no significance between CDI score and age, whether or not a dual-income family, death of a sib, hospitalization within 6 months, and family discord between husband and wife. The STAIC score was significantly higher for old age, female, sixth year students, and low school achieve menu group(P<0.01), and there was no significance between the STAIC score and residence, whether or not a dual-income family, death of a sibling, hospitalization within 6 months, and family discord between husband and wife. CONCLUSIONS: According to our results, there was a significant correlation between gender, school years, school achievement and a propensity to depression and anxiety. Therefore, family physician should be more involved in family intervention and anticipatory guidance upon medical examination and treatment, if he or she has a symptoms of anxiety and depression.