Screening for Adolescent Depression: A Comparison of Depression Scales

Investigation of the ability of two depression scales to identify cases of DSM-III-R major depression and dysthymia in a large, community sample of high school students indicates that neither the BDI nor the CES-D should be used by themselves as methods for case ascertainment in either epidemiological or experimental studies.

Abstract

The ability of two depression scales, the Center for Epidemiologic Studies Depression Scale (CES-D) and the Beck Depression Inventory (BDI), to identify cases of DSM-III-R major depression and dysthymia was investigated in a large, community sample of high school students. Receiver operating characteristics analyses indicated that different caseness criteria should be used for boys and girls for both the CES-D and the BDI. Internal consistency-reliability and sensitivity and specificity for detecting current episodes of current depression and dysthymia were adequate and comparable to those found with adult samples, but both the CES-D and the BDI generated many false positives. Multiple screening using the "serial" strategy increased positive predictive power substantially for both the CES-D and the BDI, whereas using the "parallel" strategy had very little effect on the efficacy of the two screeners. The results indicate that neither the BDI nor the CES-D should be used by themselves as methods for case ascertainment in either epidemiological or experimental studies, although the BDI does function somewhat better than the CES-D as a screener.