Depression Childhood Depression The Children's Depression Inventory (CDI) Benefits and Limitations of the CDI By Lauren DiMaria Lauren DiMaria LinkedIn Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. Learn about our editorial process Updated on October 03, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Aron Janssen, MD Medically reviewed by Aron Janssen, MD LinkedIn Aron Janssen, MD is board certified in child, adolescent, and adult psychiatry and is the vice chair of child and adolescent psychiatry Northwestern University. Learn about our Medical Review Board Print Morsa Images / DigitalVision / Getty Images Table of Contents View All Table of Contents Overview Administration Reliability Interpretation Limitations What Happens Next? If your child has been diagnosed with depression or will be evaluated for depression, you may have heard of the Children's Depression Inventory (CDI). The CDI is a tool that mental health professionals use to measure the cognitive, affective, and behavioral signs of depression in children and adolescents between the ages of 7 and 17. The CDI is used to scale the severity of depressive symptoms in children. It also differentiates between major depressive disorder and dysthymic disorder in children and helps practitioners distinguish between these disorders and other psychiatric conditions. Overview The CDI was developed by Maria Kovacs in order to more easily diagnose depression in children. While depression is often thought of as an adult disorder, the Centers for Disease Control and Prevention (CDC) reports that 4.9% of children between the ages of 6 and 17 have been diagnosed with depression. The CDI is a self-report assessment written at a first-grade reading level, which means that your child will be given the paper and pencil assessment to complete by themselves. Other self-report assessments for identifying depression in children include the Beck Depression Inventory (BDI) and the Weinberg Screening Affective Scale (WSAS). The CDI has two forms: The original 27-item version, and the 10-item short-form version, which takes between 5 and 15 minutes for the child to complete. The CDI is designed to detect symptoms of depression and to distinguish between depression and other psychiatric disorders. It can also be used as an instrument to monitor changes in depression symptoms over time. The short form of the test is generally used as a screening tool, while the long-form is used more often in the diagnosis of depression in children. What You Should Know About Childhood Depression Administration Each item in the CDI has three statements, and the child is asked to select the one answer that best describes their feelings over the past two weeks. There are five subscales within the assessment that measure different components of depression: Anhedonia (inability or decreased ability to experience joy)Ineffectiveness (lack of motivation or inability to complete tasks)Interpersonal problems (difficulty making and keeping close relationships)Negative mood (irritability or anger)Negative self-esteem (the belief that you are not good at anything) The CDI is popular in part because it is easy to administer and score. A child with age-appropriate reading abilities can complete the scale relatively quickly. Reliability The CDI has excellent psychometric properties, which means that it measures depression in children accurately and reliably when used properly. Some research indicates, however, that the test is not appropriate for children who have reading difficulties. The CDI was tested on a large group that represents the population of children in the United States. Research has also shown that the CDI (both the full version and short version) is a valid instrument when used for screening for depression in pediatric settings. However, doctors working in pediatric care are advised to follow up with diagnostic assessments to rule out potential false positives. Interpretation Only a professional trained on the properties of the CDI can accurately interpret the results. A raw score on the test is essentially meaningless without a professional's interpretation, so parents should always discuss the meaning of the results with the professional who evaluated the child. While the CDI is good at detecting the presence of depressive symptoms, it is not the best at determining their severity. You should discuss follow-up assessments with your child's doctor to determine the best course of treatment for your child. Milder symptoms may respond well to support and self-care, while more moderate to severe symptoms may require other treatments such as medications or psychotherapy. Limitations Like other self-report assessments used in children, the CDI is vulnerable to certain limitations. For example, because children don't have the same sophistication as adults related to understanding and reporting their emotions, their responses may not reflect their true emotional state. In addition, children may be more likely than adults to attempt to give what they believe to be the desired answers rather than answers that represent their true feelings. Some researchers have also observed that children who do not have age-appropriate reading skills may receive an inaccurate diagnosis on the basis of their CDI score. What Happens Next? The CDI is a quick and painless depression assessment for your child. While any type of test is sure to make a child nervous, you can assure your child that there are no right or wrong answers. Depressive symptoms tend to fluctuate in both children and adults. Therefore, the test's author recommends retesting any child who receives a positive score on the CDI two to four weeks after the initial test. In addition, a child who receives a positive score on the CDI should be referred for a comprehensive evaluation by a licensed mental health professional. If you are concerned about depression in your child, it is important to consult with your child's pediatrician or other mental health professional. It is important that childhood depression is treated quickly. How to Tell If Your Child Shows Symptoms of Depression 2 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Data and Statistics on Children's Mental Health. Allgaier AK, Fruhe B, Pietsch K, Saravo B, Baethmann M, Shulte-Korne G. Is the children's depression inventory short version a valid screening tool in pediatric care? A comparison to its full-length. Journal of Psychosomatic Research. 2012;73(5):369-374. doi:10.1016/j.jpsychores.2012.08.016 Additional Reading Frick PJ, Barry CT, Kamphaus RW. Clinical Assessment of Child and Adolescent Personality and Behavior. New York: Springer; 2009. Kovacs M. Children's Depression Inventory (CDI). New York: Multi-health Systems, Inc.; 1992. 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