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

Stephanie Salcedo, Yen Ling Chen, Eric A. Youngstrom, Mary A. Fristad, Kenneth D. Gadow, Sarah M. Horwitz, Thomas W. Frazier, L. Eugene Arnold, Mary L. Phillips, Boris Birmaher, Robert A. Kowatch, Robert L. Findling

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


This study examined the diagnostic and clinical utility of the Child and Adolescent Symptom Inventory–4 R (CASI-4 R) 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-4 R. CASI-4 R depressive symptom severity and symptom count scores each predicted mood disorder diagnoses. Both caregiver scores (symptom severity and symptom count) of the CASI-4 R 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-4 R Depression scale showed strong incrememental validity even controlling for the other CASI-4 R 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-4 R Depressive subscale caregiver report can help identify youth mood disorders, and using DLRs may help improve diagnostic accuracy.

Original languageEnglish (US)
Pages (from-to)832-846
Number of pages15
JournalJournal of Clinical Child and Adolescent Psychology
Issue number5
StatePublished - Sep 3 2018

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology


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