The Children's Depression Inventory (CDI)

Benefits and Limitations

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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 discriminates 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 herself. 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.

Administration

Each item in the CDI has three statements, and the child is asked to select the one answer that best describes her 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)
  • Negative self-esteem (the belief that you are not good at anything)
  • Ineffectiveness (lack of motivation or inability to complete tasks)
  • Interpersonal problems (difficulty making and keeping close relationships)
  • Negative mood (irritability or anger)

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 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. Parents should 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 her 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.

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