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Study questions accuracy of depression screening tools for youth

Recent findings indicated insufficient evidence for accuracy of depression screening tools for major depressive disorder in children and adolescents.

“Our study shows that if depression screening were carried out using existing screening tools, many nondepressed children and adolescents would be mistakenly identified as depressed,” Brett Thombs, PhD, of Jewish General Hospital and McGill University's Faculty of Medicine, Montreal, said in a press release.

To assess accuracy of depression screening tools for major depressive disorder (MDD) in children and adolescents, researchers conducted a systematic review of studies that compared a depression screening tool with a validated diagnostic interview for MDD among children aged 6 to 18 years. Analysis included 17 studies on 20 depression screening tools.

Few studies assessed the accuracy of the same screening tools and optimal cut-off scores were inconsistent across studies, according to researchers.

Sensitivity 95% confidence intervals (CI) ranged from 9% to 55%, with a median of 32%. One study had a lower bound 95% CI of 80% or higher.

Specificity 95% CIs ranged from 2% to 27%, with a median of 9%. Three studies had a lower bound 95% CI of 90% or higher.

Analysis was limited by small sample sizes, exploratory data analyses to identify optimal cut-offs, and failure to exclude children already diagnosed or treated for depression.

“This systematic review found that there is insufficient evidence of the ability of depression screening instruments to accurately detect MDD in children and adolescents,” the researchers wrote. “The absence of any evidence from clinical trials that depression screening would improve mental health outcomes, along with the results from this systematic review, suggests that screening children and adolescents could lead to more harm than benefit and would consume scarce mental health resources that could otherwise be used to provide treatment for underserved youth with mental disorders.” – by Amanda Oldt

Disclosure: Thombs reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.