Screening for depression
Guidance on screening varies according to country of practice. The author’s view is that children and adolescents with risk factors seen at primary care settings should be screened for major depressive disorder. Risk factors include:
Family history of mood disorder
History of trauma or recent trauma, including physical or sexual abuse or neglect
Significant psychosocial stress (e.g., parental divorce, parental depression, severe parental medical illness, loss of a loved one including pets, conflict in peer or romantic relationships, conflict with parents)
Poor performance in school
Significant change of functioning
Chronic or severe medical illness
Certain medication treatment (e.g., corticosteroids, interferon)
Recent history of giving birth.
Screening of children and adolescents with risk factors for major depressive disorder is also recommended in the emergency department setting.[63]Chun TH, Mace SE, Katz ER, et al. Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: common clinical challenges of patients with mental health and/or behavioral emergencies. Pediatrics. 2016 Sep;138(3):e20161570.
https://publications.aap.org/pediatrics/article/138/3/e20161570/52770/Evaluation-and-Management-of-Children-and
http://www.ncbi.nlm.nih.gov/pubmed/27550977?tool=bestpractice.com
Annual universal screening for depression in a primary care setting is recommended for all children ages 12 years and older, even in the absence of specific risk factors, according US-based guidance.[64]Zuckerbrot RA, Cheung A, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management. Pediatrics. 2018 Mar;141(3):e20174081.
https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary
http://www.ncbi.nlm.nih.gov/pubmed/29483200?tool=bestpractice.com
[65]US Preventive Services Task Force., Mangione CM, Barry MJ, et al. Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022 Oct 18;328(15):1534-42.
https://jamanetwork.com/journals/jama/fullarticle/2797145
http://www.ncbi.nlm.nih.gov/pubmed/36219440?tool=bestpractice.com
This approach is endorsed by the US Preventive Services Task Force (USPSTF).[65]US Preventive Services Task Force., Mangione CM, Barry MJ, et al. Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022 Oct 18;328(15):1534-42.
https://jamanetwork.com/journals/jama/fullarticle/2797145
http://www.ncbi.nlm.nih.gov/pubmed/36219440?tool=bestpractice.com
At present, the USPSTF does not recommend screening for depression in children ages 11 years or younger, based on insufficient evidence of net benefit. However, note that in children in this age group, early identification can facilitate early intervention.[66]Walter HJ, Abright AR, Bukstein OG, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. J Am Acad Child Adolesc Psychiatry. 21Oct 2022 [Epub ahead of print].
https://www.jaacap.org/article/S0890-8567(22)01852-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36273673?tool=bestpractice.com
Children who come into contact with psychiatric services always need to be screened for depression because depression is highly comorbid with other psychiatric disorders.[67]National Institute for Health and Care Excellence. Depression in children and young people: identification and management. Jun 2019 [internet publication].
https://www.nice.org.uk/guidance/ng134
Screening should be completed by direct clinician interview, in addition to one of the depression rating scales reviewed below.[64]Zuckerbrot RA, Cheung A, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management. Pediatrics. 2018 Mar;141(3):e20174081.
https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary
http://www.ncbi.nlm.nih.gov/pubmed/29483200?tool=bestpractice.com
Reynolds Adolescent/Child Depression Scales (RADS/RCDS)
The RADS/RCDS is a child- and parent-report depression instrument with useful psychometric properties.[72]Reynolds WM. Reynolds adolescent depression scale. Odessa, FL: Psychological Assessment Resources; 1987.[73]Reynolds WM. Reynolds child depression scale. Odessa, FL: Psychological Assessment Resources; 1987. It is an effective screening tool but probably not a good instrument for monitoring treatment outcomes.[74]Myers K, Winters NC. Ten-year review of rating scales. I: Overview of scale functioning, psychometric properties, and selection. J Am Acad Child Adolesc Psychiatry. 2002 Feb;41(2):114-22.
http://www.ncbi.nlm.nih.gov/pubmed/11837400?tool=bestpractice.com
It is available in multiple languages and is suitable for both children and adolescents. It is copyrighted, and therefore must be purchased from the publisher.
Mood and Feelings Questionnaire (MFQ)
The MFQ is a self-, parent-, and teacher-reported depression scale for children and adolescents.[75]Angold A, Costello EJ, Messer SC, et al. The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Meth Psychiatr Res. 1995;5:237-49. It is a good screening tool and can be used in both clinical and research settings.[76]Messer SC, Angold A, Loeber R, et al. The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: factor composition and structure across development. Int J Meth Psychiatr Res. 1995;5:251-62. It can be accessed online for clinical or research use.
Duke University: Mood and Feelings Questionnaire
Opens in new window A short version of the MFQ (MFQ-SF) was found to be sensitive in screening for major depressive disorder among youths ages 11-17 in a primary care setting.[77]Katon W, Russo J, Richardson L, et al. Anxiety and depression screening for youth in a primary care population. Ambul Pediatr. 2008 May-Jun;8(3):182-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453063
http://www.ncbi.nlm.nih.gov/pubmed/18501865?tool=bestpractice.com
Beck Depression Inventory (BDI)
The BDI is a widely used adolescent self-rated depression scale with good psychometric properties.[74]Myers K, Winters NC. Ten-year review of rating scales. I: Overview of scale functioning, psychometric properties, and selection. J Am Acad Child Adolesc Psychiatry. 2002 Feb;41(2):114-22.
http://www.ncbi.nlm.nih.gov/pubmed/11837400?tool=bestpractice.com
[78]Beck AT, Steer RA. Beck Depression Inventory (BDI) Manual. 2nd ed. San Antonio, TX: Psychological Corporation; 1993. It is copyrighted, so must be purchased from the publisher.
Child Depression Inventory (CDI)
The CDI is a 27-item, self-rated assessment of depression and/or dysthymic disorder symptoms.[79]Kovacs, M. Children’s depression inventory. North Tonawanda, NY: Multi-Health Systems, Inc; 1992. Items are grouped into 5 factor areas. The CDI is a widely used and accepted assessment for the severity of depressive symptoms with high reliability.
Patient Health Questionnaire (PHQ-9): adolescents
A depression-focussed screening tool such as the PHQ-9 is recommended by the US Preventive Sercives Task Force (USPSTF) for depression screening in adolescents.[65]US Preventive Services Task Force., Mangione CM, Barry MJ, et al. Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022 Oct 18;328(15):1534-42.
https://jamanetwork.com/journals/jama/fullarticle/2797145
http://www.ncbi.nlm.nih.gov/pubmed/36219440?tool=bestpractice.com
The PHQ-9 is a psychologic assessment for screening, diagnosing, and monitoring the severity of depression or dysthymic symptoms.[80]Richardson LP, McCauley E, Grossman DC, et al. Evaluation of the Patient Health Questionnaire-9 Item for detecting major depression among adolescents. Pediatrics. 2010 Dec;126(6):1117-23.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217785
http://www.ncbi.nlm.nih.gov/pubmed/21041282?tool=bestpractice.com
It is a brief self-report scale, and item 9 includes a screening question for suicidal ideation. Diagnostic validity has been established in primary care settings. Note that PHQ-9 contains a question on suicidality; given that a positive response necessitates urgent assessment, this is not an appropriate screening tool for remote screening when a clinician is not immediately available to monitor and act on positive responses (e.g., via patient portal in advance of well visits in primary care).[66]Walter HJ, Abright AR, Bukstein OG, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. J Am Acad Child Adolesc Psychiatry. 21Oct 2022 [Epub ahead of print].
https://www.jaacap.org/article/S0890-8567(22)01852-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36273673?tool=bestpractice.com
Depression rating scales may also facilitate measurement of response to treatment over time (''measurement-based treatment'').[66]Walter HJ, Abright AR, Bukstein OG, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. J Am Acad Child Adolesc Psychiatry. 21Oct 2022 [Epub ahead of print].
https://www.jaacap.org/article/S0890-8567(22)01852-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36273673?tool=bestpractice.com
Screening for suicidal ideation
Although the USPSTF found insufficient evidence to recommend routine screening for suicide risk in children and adolescents in primary care, the American Academy of Pediatrics (AAP) recommends that pediatricians screen all youth ages 12 years and older for suicide risk at least annually.[65]US Preventive Services Task Force., Mangione CM, Barry MJ, et al. Screening for depression and suicide risk in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022 Oct 18;328(15):1534-42.
https://jamanetwork.com/journals/jama/fullarticle/2797145
http://www.ncbi.nlm.nih.gov/pubmed/36219440?tool=bestpractice.com
[81]COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE, BRIGHT FUTURES PERIODICITY SCHEDULE WORKGROUP. 2023 Recommendations for Preventive Pediatric Health Care. Pediatrics. 2023 Apr 1;151(4):e2023061451.
https://publications.aap.org/pediatrics/article/151/4/e2023061451/190849/2023-Recommendations-for-Preventive-Pediatric
http://www.ncbi.nlm.nih.gov/pubmed/36938620?tool=bestpractice.com
The AAP notes that screening at every visit may be indicated for higher risk populations, such as those presenting with psychiatric problems such as depression.[68]Hua LL, Lee J, Rahmandar MH, et al. Suicide and suicide risk in adolescents. Pediatrics. 2024 Jan 1;153(1):e2023064800.
https://publications.aap.org/pediatrics/article/153/1/e2023064800/196189/Suicide-and-Suicide-Risk-in-Adolescents
http://www.ncbi.nlm.nih.gov/pubmed/38073403?tool=bestpractice.com
The AAP notes that the emergency department plays a key role in identifying children and youth at immediate risk for suicidality, regardless of whether they are at risk for depression. Use of a brief validated screening tool for suicidality, for example, the Ask Suicide Screening Questions (ASQ) (validated in children ages 10 years and over) or Columbia Suicide Severity Rating Scale for pediatrics (C-SSRC) (validated in children and adults ages 12 years and over) may be helpful in this setting.[82]Saidinejad M, Duffy S, Wallin D, et al. The management of children and youth with pediatric mental and behavioral health emergencies. Pediatrics. 2023 Sep 1;152(3):e2023063255.
https://publications.aap.org/pediatrics/article/152/3/e2023063255/193697/The-Management-of-Children-and-Youth-With
http://www.ncbi.nlm.nih.gov/pubmed/37584147?tool=bestpractice.com
[83]Horowitz LM, Bridge JA, Teach SJ, et al. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012 Dec;166(12):1170-6.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/1363508
http://www.ncbi.nlm.nih.gov/pubmed/23027429?tool=bestpractice.com
[84]Gipson PY, Agarwala P, Opperman KJ, et al. Columbia-suicide severity rating scale: predictive validity with adolescent psychiatric emergency patients. Pediatr Emerg Care. 2015 Feb;31(2):88-94.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037572
http://www.ncbi.nlm.nih.gov/pubmed/25285389?tool=bestpractice.com
Screening for suicidal ideation in adolescents should typically take place in a confidential manner, without caregivers present, given that young people may be reluctant to report suicidal ideation in the company of caregivers. Use of a brief suicide safety assessment (BSSA) is recommended by the AAP for all patients screening positive for suicide risk, in order to further explore their personal risk and protective factors. Note that the BSSA is different from the initial screening tool, which simply identifies risk.[69]American Academy of Pediatrics. Conducting a brief suicide safety assessment. Nov 2023 [internet publication].
https://www.aap.org/en/patient-care/blueprint-for-youth-suicide-prevention/strategies-for-clinical-settings-for-youth-suicide-prevention/conducting-a-brief-suicide-safety-assessment
It is imperative to ask about access to lethal means (firearms, medications, illicit substances, knives, ropes) in the event of a positive screen for suicidal ideation, followed by risk-tailored counseling and mitigation.[68]Hua LL, Lee J, Rahmandar MH, et al. Suicide and suicide risk in adolescents. Pediatrics. 2024 Jan 1;153(1):e2023064800.
https://publications.aap.org/pediatrics/article/153/1/e2023064800/196189/Suicide-and-Suicide-Risk-in-Adolescents
http://www.ncbi.nlm.nih.gov/pubmed/38073403?tool=bestpractice.com
[70]The President and Fellows of Harvard College. Means matter: lethal means counseling. [internet publication].
https://www.hsph.harvard.edu/means-matter/lethal-means-counseling
A positive screening result for suicidal ideation should be followed safety planning, an intervention that encompasses helping the patient identify their risk factors for suicidal ideation as well as a series of supports that they can draw on to reduce their risk of self-harm. Children and adolescents who are depressed with severe suicidality without being able to maintain safety, or with significant psychosis, require urgent referral to the emergency department. See: Suicide risk mitigation.