Depression rating scales as screening tools for depression in high school students

Abstract

BACKGROUND: Depression is a major cause of suicide among adolescents. Therefore, it is crucial to find suitable depression screening tools for this population. OBJECTIVE: To evaluate the use of depression rating scales as screening tools for depression in a sample of Brazilian high school students. METHODS: A cross-sectional study. Three scales (BDI, CES-D, and CRS) and a screening test for general psychiatric symptoms (SRQ) were administered to a sample of 503 high school students aged between 15 to 17 years. The results were compared to those obtained with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). RESULTS: The prevalence of major depression using DSM-IV criteria was 10.9%. Adolescents with major depression had significantly higher (p = 0.001) scores in the SRQ and in the three scales analyzed compared to the group without depression. The sensitivity and specificity of BDI, CES-D, and CRS were 0.77 and 0.70, 0.75 and 0.73, and 0.82 and 0.71, respectively, to screen for major depression (ROC curve). The best cutoff values to suggest depression were 9 for BDI, 10 for CSR, and 14 for CES-D. The frequency of depressive symptoms was higher in girls (approximately 2:1). DISCUSSION: The present findings support the use of the BDI, the CES-D and the CRS only for screening or as an additional symptomatic evaluation of depression in high school student. The difference in scale scores between boys and girls warns against the use of the same cutoff values for both sexes.