Department of Psychiatry, Dong-A University College of Medicine, Busan, Republic of Korea.
Psychiatry Investig. 2015 Jan;12(1):23-8. doi: 10.4306/pi.2015.12.1.23. Epub 2015 Jan 12.
The aim was to establish an optimal cut-off score of the Children's Depression Inventory (CDI) for detecting depression and rating severity in Korean adolescents.
A total of 468 students aged 12-16 years from 8 middle schools in Busan, Korea participated in this study. The Korean version of the CDI and Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version were used to evaluate depressive symptoms. Receiver-operating characteristics (ROC) analyses were conducted to evaluate case-finding performance and set the cut-off scores.
ROC analyses demonstrated that the overall discrimination power of the CDI is good enough to evaluate adolescent depression. The CDI sum score of 20 was identified as the optimal screening cut-off score, where sensitivity was 0.83 and specificity was 0.89. This cut-off score could apply regardless of subjects' gender. The cut-off scores were examined in order of the depression severity: 15 for mild, 20 for moderate, and 25 for severe depression with high sensitivity and specificity.
The CDI cut-off scores of our study can be recommended for screening depressed youth and rating the severity of depressive symptoms. The high negative predictive value suggested that the cut-off score of 20 would result in a small number of missed cases. Further studies are needed to ascertain these CDI cut-off scores for different age groups.
旨在为韩国青少年建立儿童抑郁量表（CDI）的最佳截断分数，以用于检测抑郁和评估严重程度。
本研究共纳入来自韩国釜山 8 所中学的 468 名 12-16 岁的学生。采用儿童抑郁量表（Korean version of the CDI）和儿童心境障碍和精神分裂症现患及 Lifetime 版本 Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-PL) 评估抑郁症状。采用受试者工作特征（receiver-operating characteristics，ROC）分析评估病例发现性能并确定截断分数。
ROC 分析表明，CDI 的整体判别能力足以评估青少年抑郁。CDI 总分 20 被确定为最佳筛查截断分数，此时敏感性为 0.83，特异性为 0.89。该截断分数可适用于不同性别的受试者。根据抑郁严重程度依次检查截断分数：轻度抑郁为 15，中度抑郁为 20，重度抑郁为 25，具有较高的敏感性和特异性。
本研究的 CDI 截断分数可用于筛查抑郁青少年和评估抑郁症状严重程度。高阴性预测值表明，截断分数为 20 时可能会漏诊少数病例。需要进一步研究以确定不同年龄组的 CDI 截断分数。
