Performance and Psychometric Properties of Novel Brief Assessments for Depression in Children and Adolescents

Abstract

Objective

Current rating scales for depressive symptom severity in pediatric patients do not meet the needs of contemporary clinical practice and research. This study sought to evaluate relative performance and psychometric properties of the 5-item Brief Children’s Depression Rating Scale—Revised (BCDRS-R5), as well as the clinician-rated and self-report versions of the 5-item Very Quick Inventory of Depressive Symptomatology (VQIDS-A5-C and VQIDS-A5-SR, respectively).

Method

This study examined a sample of 165 outpatients aged 8 to 17 years with major depressive disorder who were treated openly with fluoxetine for 6 weeks from a prior National Institute of Mental Health (NIMH)–funded study. We examined the internal consistency, scale dimensionality, relative performance in detecting remission and response, and sensitivity to change of each 5-item scale.

Results

All 3 brief scales had good-to-excellent internal consistency. Cronbach coefficient α values were 0.687 to 0.795 at baseline and 0.766 to 0.844 at week 6. Principal component analysis suggested a 1-factor solution for each scale. The BCDRS-R5 demonstrated a greater degree of accuracy in identifying response and remission compared to the VQIDS-A5-C and VQIDS-A5-SR. The scales were sensitive to change in symptom severity over 6 weeks of acute treatment with fluoxetine.

Conclusion

Three novel, brief scales assessing depressive symptom severity in pediatric patients showed similar performance and sensitivity to change in symptom severity over 6 weeks of acute treatment when compared with longer, standard scales.

Plain language summary

Existing assessment tools for depressive symptom severity in children and adolescents have limitations and do not meet the needs of contemporary families, clinical practice, or research efforts. The purpose of the current study, using a sample of youth with depression, was to evaluate the psychometric properties of the 5-item Brief Children's Depression Rating Scale–Revised (BCDRS-R5) as well as the 5-item Very Quick Inventory of Depressive Symptomatology self-report and clinician-rated versions (VQIDS-A5-SR/VQIDS-A5-C), compare their relative performance, and define clinically-relevant depressive symptom severity thresholds for remission. These novel, brief scales had similar performance as longer, standard scales and show promise for future use in clinical practice and research efforts.

Clinical trial registration information

Sequential Treatment of Pediatric MDD to Increase Remission and Prevent Relapse; https://clinicaltrials.gov/study/NCT00612313.