The Children's Depression Inventory (CDI)

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 Children's Depression Inventory is used to scale the severity of depressive symptoms in children. It also differentiates between major depressive disorder and persistent depressive disorder (formerly known as dysthymic disorder) in children. It can help practitioners distinguish between these disorders and other psychiatric conditions. 

How the Children's Depression Inventory Works

The CDI was developed by Maria Kovacs to diagnose depression in children more easily. Other self-report assessments for identifying depression in children include the Beck Depression Inventory (BDI) and the Weinberg Screening Affective Scale (WSAS). 

While depression is often considered an adult disorder, the Centers for Disease Control and Prevention (CDC) states that 4.4% of kids between the ages of 3 and 17 have been diagnosed with depression.

The Children's Depression Inventory 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.

How Is the Children's Depression Inventory Administered?

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)
  

How Reliable Is the Children's Depression Inventory?

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. 

Research has also shown that the Children's Depression Inventory (both the full version and short version) is a valid instrument for screening for depression in pediatric settings. It has also been validated for use with children who have physical disabilities.

However, doctors working in pediatric care are advised to follow up with diagnostic assessments to rule out potential false positives. 

Interpreting the Children's Depression Inventory 

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.

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 of the Children's Depression Inventory

Like other self-report assessments used in children, the Children's Depression Inventory is vulnerable to certain limitations. For example, because children don't have the same sophistication as adults when it comes 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.

While the inventory has five subscales, some studies have failed to support the five-factor structure. Instead, some researchers indicate that two-, three-, or four-factor models are a better fit. 

The use of the CDI for children outside of the U.S. may be limited due to cultural-specific interpretations. One study found that demographic and socio-cultural factors influenced the interpretation of depressive symptoms. This suggests that more research is needed to ensure the CDI is valid in cultures outside the U.S.

What Happens Next?

The Children's Depression Inventory 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.  

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.

Childhood depression can have serious consequences, particularly when it is left untreated. It can affect a child's personal development, well-being, health, and academic achievement. Such effects can also carry over into adulthood.

Detecting childhood depression early and treating it effectively can help kids feel better and protect their well-being as they develop.