The ability of YSR DSM-oriented depression scales to predict DSM-IV depression in young adults: A longitudinal study

Background: The Achenbach child behaviour checklist (CBCL/YSR) is a widely used screening tool for affective problems. Several Studies report good association between the checklists and psychiatric diagnoses; although with varying degrees of agreement. Most are cross-sectional Studies involving adolescents referred to mental health services. This paper aims to evaluate the performance of the youth self report (YSR) empirical and DSM-oriented internalising scales in predicting later depressive disorders in young adults. Methods: Sample was 2431 Young adults from an Australian birth cohort study. The strength of association between the empirical and DSM-oriented scales assessed at 14 and 21 years and structured-interview derived depression in young adulthood (18 to 22 years) were tested using odds ratios, ROC analyses and related diagnostic efficiency tests (sensitivity, specificity, positive and negative predictive values). Results: Adolescents with internalising symptoms were twice (OR 2.3, 95%Cl 1.7 to 3.1) as likely to be diagnosed with DSM-IV depression by age 21. Use of DSM-oriented depressive scales did not improve the concordance between the internalising behaviour and DSM-IV diagnosed depression at age 14 (ORs ranged from 1.9 to 2.5). Limitations: Some loss to follow-up over the 7-year gap between the two waves of follow-up. Conclusion: DSM-oriented scales perform no better than the standard internalising or anxious/depressed scales in identifying young adults with later DSM-IV depressive disorder. (C) 2009 Elsevier B.V. All rights reserved.