Abstract

Research Article

Screening for Depressive Symptoms in Clinical and Nonclinical Youth: The Psychometric Properties of the Dutch Children’s Depression Inventory-2 (CDI-2)

Denise Bodden*

Published: 24 December, 2025 | Volume 9 - Issue 1 | Pages: 028-039

Objective: This study investigated the utility of the second version of the Children’s Depression Inventory (CDI-2) as a screening tool to identify children and adolescents aged 8-21 years suffering from depressive symptoms. 
Method: Data were collected by combining questionnaire data from multiple clinical and control subsamples in which the CDI-2 child and parent version were administered to clinically depressed children (n = 111), children with other psychiatric disorders (n = 74) and control children (n = 2246) as well as their parents (respectively n = 104, n = 112, n = 2130). 
Results: Results showed that the CDI-2 has good psychometric properties in terms of internal consistency, factor structure, parent-child agreement, convergent and divergent validity. However, the factor structure of the parent version was insufficient. The CDI-2 total score of the child version and parent version can differentiate between clinically depressed children, children with other psychiatric disorders, and control children. Further, reliable cut-off scores were established. There were also significant gender and age effects.
Conclusion: The total score of the CDI-2 child and parent version can be used as a screening tool to detect clinically significant depressive symptoms in children and adolescents. 

Read Full Article HTML DOI: 10.29328/journal.ida.1001047 Cite this Article Read Full Article PDF

Keywords:

Depressive symptoms; Questionnaire; youth; Psychometric properties; Children and adolescents; Screening; CDI-2 (Children’s Depression Inventory-2)

References

  1. Copeland WE, McGinnis E, Bai Y, Adams Z, Nardone H, Devadanam V, et al. Impact of COVID-19 pandemic on college student mental health and wellness. J Am Acad Child Adolesc Psychiatry. 2021;60(1):134-141.e2. Available from: https://doi.org/10.1016/j.jaac.2020.08.466
  2. Crockett MA, Martínez V, Jiménez-Molina Á. Subthreshold depression in adolescence: gender differences in prevalence, clinical features, and associated factors. J Affect Disord. 2020;272:269-276. Available from: https://doi.org/10.1016/j.jad.2020.03.111
  3. Wesselhoeft R, Sørensen MJ, Heiervang ER, Bilenberg N. Subthreshold depression in children and adolescents: a systematic review. J Affect Disord. 2013;151(1):7-22. Available from: https://doi.org/10.1016/j.jad.2013.06.010
  4. Carrellas NW, Biederman J, Uchida M. How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review. J Affect Disord. 2017;210:166-173. Available from: https://doi.org/10.1016/j.jad.2016.12.037
  5. Shorey S, Ng ED, Wong CH. Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and meta-analysis. Br J Clin Psychol. 2022;61(2):287-305. Available from: https://doi.org/10.1111/bjc.12333
  6. Sigalas PD, Barkla X, McArdle P. Underdiagnosis of depression in young people. BMJ. 2014;348:g170. Available from: https://doi.org/10.1136/bmj.g170
  7. Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. 2012;379:1056-1067. Available from: https://doi.org/10.1016/S0140-6736(11)60871-4
  8. Cuijpers P, van Straten A, Smits N, Smit F. Screening and early psychological intervention for depression in schools: systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2006;15:300-307. Available from: https://doi.org/10.1007/s00787-006-0537-4
  9. Siu AL, US Preventive Services Task Force. Screening for depression in children and adolescents: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(5):360-366. Available from: https://doi.org/10.7326/M15-2957
  10. Cheung AH, Zuckerbrot RA, Jensen PS, Laraque D, Stein RE, Glad-PC Steering Group, Sarvet B. Guidelines for adolescent depression in primary care (GLAD-PC): part II. Treatment and ongoing management. Pediatrics. 2018;141(3):e20174082. Available from: https://doi.org/10.1542/peds.2017-4082
  11. Beck A, Dryburgh N, Bennett A, Shaver N, Esmaeilisaraji L, Skidmore B, et al. Screening for depression in children and adolescents in primary care or non-mental health settings: a systematic review update. Syst Rev. 2024;13(1):48. Available from: https://doi.org/10.1186/s13643-023-02447-3
  12. Kovacs M. Children’s Depression Inventory manual. Toronto: Multi-Health Systems; 1992. Available from: https://www.scienceopen.com/book?vid=761e0bdc-c7a2-44a1-9730-c8aa4bed7424
  13. Bernaras E, Jaureguizar J, Garaigordobil M. Child and adolescent depression: a review of theories, evaluation instruments, prevention programs, and treatments. Front Psychol. 2019;10:543. Available from: https://doi.org/10.3389/fpsyg.2019.00543
  14. Beck AT, Rush AJ, Shaw B, Emery G. Cognitive therapy of depression. New York: Guilford Press; 1979. Available from: https://books.google.co.in/books/about/Cognitive_Therapy_of_Depression.html?id=L09cRS0xWj0C
  15. Gomez R, Vance A, Gomez A. Children’s Depression Inventory: invariance across children and adolescents with and without depressive disorders. Psychol Assess. 2012;24:1-10. Available from: https://doi.org/10.1037/a0024966
  16. Roelofs J, Braet C, Rood L, Timbremont B, van Vlierberghe L, Goossens L, et al. Norms and screening utility of the Dutch version of the Children’s Depression Inventory in clinical and nonclinical youth. Psychol Assess. 2010;22:866-877. Available from: https://doi.org/10.1037/a0020593
  17. Timbremont B, Braet C, Dreesen L. Assessing depression in youth: relation between the Children’s Depression Inventory and a structured interview. J Clin Child Adolesc Psychol. 2004;33:149-157. Available from: https://doi.org/10.1207/s15374424jccp3301_14
  18. Huang C, Dong N. Dimensionality of the Children’s Depression Inventory: meta-analysis of pattern matrices. J Child Fam Stud. 2014;23:1182-1192. Available from: https://doi.org/10.1007/s10826-013-9779-1
  19. Jelínek M, Květon P, Burešová I, Klimusová H. Measuring depression in adolescence: evaluation of a hierarchical factor model of the Children’s Depression Inventory and measurement invariance across boys and girls. PLoS One. 2021;16(4):e0249943. Available from: https://doi.org/10.1371/journal.pone.0249943
  20. Lee YS, Krishnan A, Park YS. Psychometric properties of the Children’s Depression Inventory: an item response theory analysis across age in a nonclinical, longitudinal, adolescent sample. Meas Eval Couns Dev. 2012;45(2):84-100. Available from: https://eric.ed.gov/?id=EJ956346
  21. Cole DA, Hoffman K, Tram JM, Maxwell SE. Structural differences in parent and child reports of children's symptoms of depression and anxiety. Psychol Assess. 2000;12(2):174-185. Available from: http://dx.doi.org/10.1037/1040-3590.12.2.174
  22. Kazdin AE, Esveldt-Dawson K, Unis AS, Rancurello MD. Child and parent evaluations of depression and aggression in psychiatric inpatient children. J Abnorm Child Psychol. 1983;11(3):401-413. Available from: https://doi.org/10.1007/bf00914248
  23. Kazdin AE, French NH, Unis AS. Child, mother, and father evaluations of depression in psychiatric inpatient children. J Abnorm Child Psychol. 1983;11:167-180. Available from: https://doi.org/10.1007/bf00912083
  24. Kazdin AE, French NH, Unis AS, Esveldt-Dawson K, Sherick RB. Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. J Consult Clin Psychol. 1983;51(4):504-510. Available from: https://doi.org/10.1037/0022-006X.51.4.504
  25. Wierzbicki M. A parent form of the Children's Depression Inventory: reliability and validity in nonclinical populations. J Clin Psychol. 1987;43(4):390-397. Available from: https://doi.org/10.1002/1097-4679(198707)43:4%3C390::aid-jclp2270430409%3E3.0.co;2-s
  26. Stark KD, Laurent J. Joint factor analysis of the children’s depression inventory and the revised children’s manifest anxiety scale. J Clin Child Psychol. 2001;30:552-567. Available from: https://doi.org/10.1207/s15374424jccp3004_11
  27. Carey MR, Faulstich ME, Gresham FM, Ruggiero L, Enyart P. Children's Depression Inventory: construct and discriminant validity across clinical and nonreferred (control) populations. J Consult Clin Psychol. 1987;55:755-761. Available from: https://doi.org/10.1037/0022-006X.55.5.755
  28. Saylor CF, Finch AJ, Spirito A, Bennett B. The Children’s Depression Inventory: a systematic evaluation of psychometric properties. J Consult Clin Psychol. 1984;52:955-967. Available from: https://doi.org/10.1037/0022-006X.52.6.955
  29. Hodges KK, Craighead WE. Relationships of the Children's Depression Inventory factors to diagnosed depression. Psychol Assess. 1990;2:489-492. Available from: https://awspntest.apa.org/doi/10.1037/1040-3590.2.4.489
  30. Matthey S, Petrovski P. The Children’s Depression Inventory: error in cutoff scores for screening purposes. Psychol Assess. 2002;14:146-149. Available from: https://doi.org/10.1037/1040-3590.14.2.146
  31. Nolen-Hoeksema S. Gender differences in depression. In: Gotlib IH, Hammen CI, editors. Handbook of depression. New York: Guilford Press; 2002;492-509. Available from: https://doi.org/10.3109/09540261.2010.492391
  32. Finch AJ, Saylor CF, Edwards GL. Children's Depression Inventory: sex and grade norms for normal children. J Consult Clin Psychol. 1985;53(3):424-425. Available from: https://doi.org/10.1037/0022-006X.53.3.424
  33. van Beek Y, Berg A. Does less optimal nonverbal communication with peers predict the development of depression in adolescent boys and girls? J Abnorm Child Psychol. 2019;1-11. Available from: https://doi.org/10.1007/s10802-019-00517-6
  34. Twenge JM, Nolen-Hoeksema S. Age, gender, race, socioeconomic status, and birth cohort differences on the Children’s Depression Inventory: a meta-analysis. J Abnorm Psychol. 2002;111:578-588. Available from: https://psycnet.apa.org/doi/10.1037/0021-843X.111.4.578
  35. Bertha EA, Balazs J. Subthreshold depression in adolescence: a systematic review. Eur Child Adolesc Psychiatry. 2013;22(10):589-603. Available from: https://doi.org/10.1007/s00787-013-0411-0
  36. Kovacs M. Children’s Depression Inventory, 2nd ed. Toronto (Canada): Multi-Health Systems; 2011. Available from: https://www.apa.org/obesity-guideline/depression-inventory.pdf
  37. Alexandrou G, Karanikola M, Chatzittofis A, Sokratous S. Reliability and validity of the full-length Greek-Cypriot version of the Children's Depression Inventory 2. Psychiatr Res Clin Pract. 2025. Available from: https://doi.org/10.1176/appi.prcp.20250033
  38. Cumba-Avilés E. Systematic review on the use of the children’s depression inventory-2 among Hispanics. Hisp J Behav Sci. 2020;42(2):191-214. Available from: https://doi.org/10.1177/0739986320915170
  39. Cho Y, Lee EH, Hong SH, Joung YS, Kim JH. Reliability and validity of the Korean version of Children’s Depression Inventory 2 short version as a screening tool: a comparison with the standard 28-item version. Psychiatry Investig. 2022;19(1):54. Available from: https://doi.org/10.30773/pi.2021.0296
  40. Anant N, Kaur D, Nadarajan R, Phua DY, Chong YS, Gluckman PD, et al. Validating the Children’s Depression Inventory-2: results from the growing up in Singapore towards healthy outcomes (GUSTO) study. PLoS One. 2023;18(5):e0286197. Available from: https://doi.org/10.1371/journal.pone.0286197
  41. Ayadi H, Boudabous J, Kerkeni A, Kraiem M, Yaich S, Moalla Y. Tunisian validation of the Children’s Depression Inventory-2 in school-based children. Curr Psychiatry Res Rev. 2025;21(3):389-399. Available from: http://dx.doi.org/10.2174/0126660822272709231213062846
  42. Bae Y. Review of Children's Depression Inventory 2 (2nd ed.). J Psychoeduc Assess. 2012;30(3):304-308. Available from: https://doi.org/10.1177/0734282911426407
  43. Stikkelbroek Y, Bodden DHM, Dekovic M, van Baar AL. Effectiveness and cost effectiveness of cognitive behavioral therapy in clinically depressed adolescents: individual CBT versus treatment as usual. BMC Psychiatry. 2013;13:314. Available from: https://doi.org/10.1186/1471-244X-13-314
  44. Rasing SP, Creemers DH, Janssens JM, Scholte RH. Effectiveness of depression and anxiety prevention in adolescents with high familial risk: study protocol for a randomized controlled trial. BMC Psychiatry. 2013;13:316. Available from: https://doi.org/10.1186/1471-244X-13-316
  45. Bodden D, Braet C, Stikkelbroek Y. CDI-2 questionnaire for depression in children and adolescents: manual. Amsterdam: Hogrefe Publishers B.V.; 2016. Available from: https://www.hogrefe.com/nl/shop/cdi-2-vragenlijst-voor-depressie-bij-kinderen-en-jongeren.html
  46. Timbremont B, Braet C. Handleiding Children’s Depression Inventory. Lisse: Swets Test Publishers; 2002. Available from: https://books.google.co.in/books/about/CDI.html?id=oR56zwEACAAJ
  47. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Ryan N. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980-988. Available from: https://doi.org/10.1097/00004583-199707000-00021
  48. Reichart CG, Wals M, Hillegers M. Translation of K-SADS. Utrecht: HC Rümke Group; 2000.
  49. Achenbach TM. Manual for the Youth Self-Report and 1991 profiles. Burlington (VT): Department of Psychiatry, University of Vermont; 1991. Available from: https://www.scirp.org/reference/referencespapers?referenceid=1246863
  50. Verhulst FC, van der Ende J, Koot HM. Handleiding voor de Youth Self-Report (YSR). Rotterdam: Sophia Kinderziekenhuis, Erasmus MC; 1997. Available from: https://pure.eur.nl/en/publications/handleiding-voor-de-youth-self-report-ysr/
  51. Achenbach TM. Manual for the Child Behavior Checklist/4-18 and 1991 profiles. Burlington (VT): Department of Psychiatry, University of Vermont; 1991. Available from: https://www.scirp.org/reference/referencespapers?referenceid=79550
  52. Verhulst FC, van der Ende J, Koot HM. Manual for the CBCL/4-18. Rotterdam: Sophia Children's Hospital, Erasmus MC; 1996. Available from: https://www.scirp.org/reference/referencespapers?referenceid=1709339
  53. Muthén L, Muthén B. Mplus user’s guide. Los Angeles (CA): Muthén & Muthén; 1998–2017. Available from: https://www.scirp.org/reference/referencespapers?referenceid=2253227
  54. Flora DB, Curran PJ. An evaluation of alternative methods for confirmatory factor analysis with ordinal data. Psychol Methods. 2004;9:466-491. Available from: https://doi.org/10.1037/1082-989X.9.4.466
  55. Chen F, Curran PJ, Bollen KA, Kirby J, Paxton P. An empirical evaluation of the use of fixed cutoff points in RMSEA test statistic in structural equation models. Sociol Methods Res. 2008;36(4):462-494. Available from: https://doi.org/10.1177/0049124108314720
  56. Hu L, Bentler PM. Evaluating model fit. In: Hoyle RH, editor. Structural equation modeling: concepts, issues and applications. Thousand Oaks (CA): Sage Publications; 1995;76-99. Available from: https://www.scirp.org/reference/referencespapers?referenceid=1015696
  57. Yu CY. Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes [doctoral dissertation]. Los Angeles (CA): University of California; 2002. Available from: https://www.statmodel.com/download/Yudissertation.pdf
  58. Kline RB. Principles and practice of structural equation modeling. New York: Guilford Press; 2005. Available from: https://dl.icdst.org/pdfs/files4/befc0f8521c770249dd18726a917cf90.pdf
  59. Mul D. Puberteitsontwikkeling van Nederlandse kinderen. Tijdschr Seksuologie. 2004;28:82-86. Available from: https://www.tijdschriftvoorseksuologie.nl/images/content/pdfs/2004-28-2%20Puberteitsontwikkeling%20van%20Nederlandse%20kinderen.pdf
  60. Weiss B, Weisz JR, Politano M, Carey M, Nelson WM, Finch AJ. Developmental differences in the factor structure of the Children's Depression Inventory. Psychol Assess. 1991;3:38-45. Available from: https://weiszlab.fas.harvard.edu/sites/g/files/omnuum9551/files/jweisz/files/weiss_weisz_politano_et_al_1991_a_journal_of_cons_and_clinc_psych.pdf
  61. De Los Reyes A, Kazdin AE. Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull. 2005;131:483-509. Available from: https://doi.org/10.1037/0033-2909.131.4.483
  62. De Los Reyes A, Augenstein TM, Wang M, Thomas SA, Drabick DAG, Burgers DE, Rabinowitz J. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull. 2015;141(4):858-900. Available from: https://psycnet.apa.org/doi/10.1037/a0038498
  63. Pavuluri M, Birmaher B. A practical guide to using ratings of depression and anxiety in child psychiatric practice. Curr Psychiatry Rep. 2004;6:108-116. Available from: https://link.springer.com/article/10.1007/s11920-004-0050-8
  64. Bivins EJ, Buckland EK, Pinciotti CM, Riddle DB. Parent-child agreement on depressive symptoms in depressed and suicidal youth. J Child Fam Stud. 2025;34:2358-2368. Available from: https://link.springer.com/article/10.1007/s10826-025-03159-z
  65. Muris P, Bodden D, Hale W, Birmaher B, Mayer B. SCARED-NL. Vragenlijst over angst en bang-zijn bij kinderen en adolescenten. Handleiding bij de gereviseerde Nederlandse versie van de Screen for Child Anxiety Related Emotional Disorders. Amsterdam: Boom Test Uitgevers; 2007. Available from: https://pure.eur.nl/en/publications/scared-nl-vragenlijst-over-angst-en-bang-zijn-bij-kinderen-en-ado/
  66. King CA, Katz SH, Ghaziuddin N, Brand E, Hill E, McGovern L. Diagnosis and assessment of depression and suicidality using the NIMH Diagnostic Interview Schedule for Children (DISC-2.3). J Abnorm Child Psychol. 1997;25:173-181. Available from: https://doi.org/10.1023/A:1025739730823
  67. Löchner J, Hämmerle S, Ghezih S, Starman-Wöhrle K, Schulte-Körne G, Platt B. Parent-child agreement on children's psychopathology and the impact of parental depression. Int J Methods Psychiatr Res. 2023;33(1):e1993. Available from: https://doi.org/10.1002/mpr.1993
  68. Clark LA, Watson D. Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J Abnorm Psychol. 1991;100:316-336. Available from: https://doi.org/10.1037/0021-843X.100.3.316
  69. Boots DP, Wareham J, Weir H. Gendered perspectives on depression and antisocial behaviors: an extension of the failure model in adolescents. Crim Justice Behav. 2011;38:63-84. Available from: https://doi.org/10.1177/0093854810388504
  70. Lewinsohn PM, Clarke GN, Seeley JR, Rohde P. Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry. 1994;33:809-818. Available from: https://doi.org/10.1097/00004583-199407000-00006
  71. Breslau J, Gilman SE, Stein BD, Ruder T, Gmelin T, Miller E. Sex differences in recent first-onset depression in an epidemiological sample of adolescents. Transl Psychiatry. 2017;7(5):e1139. Available from: https://doi.org/10.1038/tp.2017.105
  72. Fristad MA, Emery BL, Beck SJ. Use and abuse of the Children’s Depression Inventory. J Consult Clin Psychol. 1997;65:699-702. Available from: https://doi.org/10.1037/0022-006X.65.4.699
  73. Beck JS, Beck AT, Jolly JB. Beck Youth Inventories manual. San Antonio (TX): Psychological Corporation; 2001. Available from: https://eprovide.mapi-trust.org/instruments/beck-youth-inventories-second-edition

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