| ORIGINAL ARTICLE |
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| Year : 2010 | Volume
: 64
| Issue : 2 | Page : 72-80 |
Validation of the children's depression rating scale- revised for adolescents in primary-care pediatric use in India
Mona M Basker1, Paul Swamidhas Sudhakar Russell2, Sushila Russell2, Prabhakar D Moses1
1 Department of Pediatrics, Division of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Psychiatry, Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, Tamil Nadu, India
Correspondence Address:
Paul Swamidhas Sudhakar Russell
Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore - 632 002, Tamil Nadu
India
DOI: 10.4103/0019-5359.94403
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. Aim: We studied the diagnostic accuracy, reliability, and validity of Children's Depression Rating Scale - Revised (CDRS-R) for primary care pediatrics. Setting and Design: Prospective study in three schools in Southern India. Materials And 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. Conclusion: The CDRS-R showed strong psychometric properties and is now available for use in the primary-care pediatric practice in India.
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