Screening efficiency of the Revised Children’s Anxiety and Depression Scale (RCADS) across age and gender in a clinical sample

Abstract

Anxiety and depressive disorders are highly prevalent in youth and are associated with substantial morbidity and an increased risk of suicidal behavior. It is therefore vital that the rating scales used in clinical practice discriminate adequately between youth with a disorder from those without to identify those who require treatment. The objective of this study was to evaluate the screening efficiency of the Revised Child Anxiety and Depression Scale (RCADS) and the use of multiple informants for subgroups of children versus adolescents and boys versus girls. The sample included 139 treatment-seeking Icelandic youth (aged 6-18 years, Mage = 12.81, 54.0% girls) and their parents. Receiver operating characteristic analyses were conducted to examine how efficiently the RCADS predicted the presence of anxiety or depressive disorders. Sequential logistic regression analyses were conducted to examine whether adding information from parents’ reports to the youths’ reports, and vice versa, would increase the identification of youth with anxiety or depressive disorders. Findings showed that the depression scale adequately predicted depressive disorders in this sample (independently of age and gender) and that the anxiety scale predicted anxiety disorders with low/moderate accuracy. However, the youth report for the anxiety scale showed limited screening utility for children and could not predict anxiety in girls. Nevertheless, both youth and parents provided valuable information, contributing to a correct diagnosis of anxiety disorders for children and girls. These results suggest that the RCADS is useful for screening anxiety and depressive symptoms in clinical populations. However, information from both youth and parent is needed when screening for anxiety in children and girls.