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Depression screening inaccurate for children, teens, researchers say

By Stephen Feller
Researchers suggest many children and adolescents are being misdiagnosed with depression after a review of studies suggested a lack of evidence most screening methods work. Photo by SanchaiRat/Shutterstock
Researchers suggest many children and adolescents are being misdiagnosed with depression after a review of studies suggested a lack of evidence most screening methods work. Photo by SanchaiRat/Shutterstock

MONTREAL, Aug. 2 (UPI) -- Depression can be a debilitating condition, especially for children, but researchers in Canada warn that recommended screening questionnaires may be leading to misdiagnosis.

A review of studies on screening techniques for depression in children and adolescents reveals insufficient evidence that they are accurate, according to researchers at McGill University.

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The U.S. Preventive Service Task Force recommends screening all adolescents for depression between the ages of 12 and 18, though it is not recommended as standard care in Canada or England.

The risk of screening all adolescents, regardless of showing or expressing symptoms of depression, with lackluster questionnaires risks misdiagnosis and the potential for children to be treated with drugs they don't need, in addition to any harm the unnecessary care causes. According to the new study, that risk is significant.

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"There was not a single tool with even moderate evidence of sufficient accuracy to effectively identify depressed children and adolescents without also incorrectly picking up many non-depressed children and adolescents," Dr. Michelle Roseman, a researcher at Jewish General Hospital in Montreal and lead author of the study, said in a press release.

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For the study, published in the Canadian Journal of Psychiatry, the researchers analyzed 17 studies with data on 20 depression screening tools, most of which were compared to validated diagnostic interviews for major depressive disorder.

Overall, the researchers report none of the studies examined the accuracy of screening tools, and in many cases the studies were too small, standards for data analysis were inconsistent and most of the studies did not exclude children and teens who'd already been diagnosed or treated for depression.

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As a result of the data review, the researchers recommend larger, better designed studies consider treatment results and better standardized measures for diagnosing depression.

"Our study shows that if depression screening were carried out using existing screening tools, many non-depressed children and adolescents would be mistakenly identified as depressed," said Brett Thombs, a researcher at Jewish General Hospital's Lady Davis Institute for Medical Research and McGill University's Faculty of Medicine.

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