Is the Children's Depression Inventory Short version a valid screening tool in pediatric care? A comparison to its full-length version

Objective: This is the first study to validate and to compare the Children's Depression Inventory (CDI) and its short version (CDI:S) as screening tools for medically ill children.

Methods: A sample of 406 pediatric hospital patients, aged 9 to 12 years (56.2% male, 77.1% inpatients), completed the German CDI. Criterion validity of the 26-item CDI and the 10-item CDI:S was calculated by receiver operating characteristic (ROC) curves. DSM-IV diagnoses of depression based on the structured diagnostic interview for mental disorders in children and adolescents (Kinder-DIPS) served as the reference standard. Areas under the ROC curves as well as sensitivities and specificities for the optimal cutoffs were compared for both versions.

Results: Diagnoses of major or minor depression were established for 7.4% of the children. Areas under the curve for the 26-item CDI (87.7%) and the 10-item CDI:S (88.2%) were comparable. For the CDI, the cutoff≥12 yielded the best balance between sensitivity (83.3%) and specificity (82.7%). At the optimal cutoff≥3, the CDI:S resulted in a high sensitivity of 93.3% and a specificity of 70.7%. Thus, the CDI:S proved to be as sensitive as the CDI, but was less specific than the full-length version.

Conclusion: Both the CDI and the CDI:S are valid screening instruments for depression in medically ill children. The sensitive and brief CDI:S is a promising tool in time-pressed settings such as pediatric care, but has to be followed by a thorough diagnostic assessment to rule out false positive cases.