(CDRS™-R) Children's Depression Rating Scale™, Revised

BY ELVA O. POZNANSKI, MD AND HARTMUT B. MOKROS, PHD

Modeled after the Hamilton Rating Scale for Depression, the Children’s Depression Rating Scale has long been used to diagnose depression and determine its severity. This version, updated and standardized, with complete interpretive and psychometric data, is more useful than ever. In clinical settings, it can be used to diagnose depression and monitor treatment response. In nonclinical contexts, such as schools and pediatric clinics, it can be used as a quick and economical screener, identifying children who need professional intervention.

The CDRS-R is a brief rating scale based on a semistructured interview with the child (or an adult informant who knows the child well). Designed for 6- to 12-year-olds and successfully used with adolescents, it can be administered in just 15 to 20 minutes and easily scored in a few minutes more. The interviewer rates 17 symptom areas (including those that serve as DSM-IV criteria for a diagnosis of depression):

• Impaired Schoolwork
• Difficulty Having Fun
• Social Withdrawal
• Appetite Disturbance
• Sleep Disturbance
• Excessive Fatigue
• Physical Complaints
• Irritability
• Excessive Guilt
• Low Self-Esteem
• Depressed Feelings
• Morbid Ideation
• Suicidal Ideation
• Excessive Weeping
• Depressed Facial Affect
• Listless Speech
• Hypoactivity

Most of these symptom areas are rated on a 7-point scale—so the CDRS-R can capture slight but notable changes in a child’s symptoms. This makes the scale ideal for monitoring symptoms during illness or remission. Other additions to the scale include suggested interview prompts and guidelines for integrating information from multiple informants.

The CDRS-R gives you a single Summary Score (a T-score), with an interpretation of, and recommendations for, six different score ranges. If applicable, it also compares ratings based on different sources (e.g., parent and child interviews) for each of the 17 symptom areas—and notes clinically significant results. Norms are derived from a nonclinical sample of children who were directly interviewed. The Manual provides interpretive guidelines for CDRS-R scores based on parent interviews.

Unlike self-report inventories, the CDRS-R not only assesses depression, but also takes the first step in the therapeutic process. A direct interview engages children who are isolated and withdrawn (as most depressed children are), bringing them into positive contact and interaction. Using the CDRS-R, treatment begins with evaluation.