Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscale for Identifying Youth Mood Disorders.

This study examined the diagnostic and clinical utility of the Child and Adolescent Symptom Inventory-4R (CASI-4R) Depressive and Dysthymia subscale for detecting mood disorders in youth (ages 6-12; M=9.37) visiting outpatient mental health clinics. Secondary analyses (N=700) utilized baseline data from the Longitudinal Assessment of Manic Symptoms study. Semistructured interviews with youth participants and their parents/caregivers determined psychiatric diagnoses. Caregivers and teachers completed the CASI-4R. CASI-4R depressive symptom severity and symptom count scores each predicted mood disorder diagnoses. Both caregiver scores (symptom severity and symptom count) of the CASI-4R subscale significantly identified youth mood disorders (areas under the curve [AUCs]=.78-.79, ps<.001). The symptom severity version showed a small but significant advantage. Teacher symptom severity report did not significantly predict mood disorder diagnosis (AUC=.56, p>.05), whereas the teacher symptom count report corresponded to a small effect size (AUC=.61, p<.05). The CASI-4R Depression scale showed strong incrememental validity even controlling for the other CASI-4R scales. Caregiver subscale cutoff scores were calculated to assist in ruling in (diagnostic likelihood ratio [DLR]=3.73) or ruling out (DLR=0.18) presence of a mood disorder. The CASI-4R Depressive subscale caregiver report can help identify youth mood disorders, and using DLRs may help improve diagnostic accuracy.