SADS in Children - KQ2

Project Summary Title and Description

SADS in Children - KQ2
Screening for Anxiety Depression and Suicide Risk in Children and Adolescents - KQ2 Diagnostic Accuracy
Authors of Report
Meera Viswanathan, PhD Ina Wallace, PhD Jennifer Cook Middleton, PhD Sara M. Kennedy, MPH Joni McKeeman, PhD Kesha Hudson, PhD Caroline Rains, MPH Emily B. Vander Schaaf, MD, MPH Leila Kahwati, MD, MPH
Methodology description
Systematic Review
doi: 10.1001/jama.2022.16303.
Background: Mental health conditions in children and adolescents may present as physical symptoms and may occur concurrently, presenting primary care physicians with opportunities to screen for one or more conditions. Purpose: To review the evidence on screening (benefits and harms of screening, accuracy of screening, benefits and harms of treatment) for suicide risk, anxiety, and depression in children and adolescents in settings relevant to primary care in the United States for the U.S. Preventive Services Task Force. Data Sources: PubMed, the Cochrane Library, PsycINFO, CINAHL and trial registries through July 19, 2021; bibliographies from retrieved articles, outside experts, and surveillance of the literature through June 1, 2022. Study Selection: Two investigators independently selected English-language studies using a priori defined criteria. We included trials that evaluated the benefits or harms of screening for suicide risk, anxiety, or depression compared with no screening or usual care. We included studies of screening with instruments feasible in primary care settings. For treatment benefits and harms, we included drugs approved for pediatric use by the Food and Drug Administration. For suicide and depression treatment studies, we included any eligible psychotherapy or collaborative care interventions. For anxiety, we restricted nonpharmacological interventions to cognitive behavioral therapy (CBT). Eligible outcomes included test accuracy, symptoms, response, remission, loss of diagnosis, all-cause mortality, functioning, suicide-related symptoms or events, withdrawal due to adverse events, serious adverse events, and harms from screening. We also included systematic reviews reporting on harms of treatment. We excluded studies with poor methodological quality. Data Extraction: One investigator extracted data and a second checked accuracy. Two reviewers independently rated methodological quality for all included studies. When at least three similar studies were available, we conducted meta-analyses. Link to full report:
Funding Source
AHRQ Contract No. HHSA-290-2015-00011-I, Task Order No. 15

Key Questions

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48. Key Question 2. Do instruments to screen for depression, anxiety, or suicide risk accurately identify children and adolescents with depression, anxiety, and increased risk of suicide in primary care or comparable settings?

Associated Extraction Forms


Associated Studies (each link opens a new tab)

Title Authors Year
The Revised Mental Health Inventory-5 (MHI-5) as an ultra-brief screening measure of bidimensional mental health in children and adolescents M. Rivera-Riquelme, J. A. Piqueras, P. Cuijpers 2019
The development and evaluation of the paediatric index of emotional distress (PI-ED) S. O'Connor, E. Ferguson, T. Carney, E. House, R. C. O'Connor 2016
Brief Measures to Screen for Social Anxiety in Adolescents L. J. Garcia-Lopez, A. J. Sez-Castillo, D. Beidel, A. M. La Greca 2015
Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population J. Canals, C. Hernndez-Martnez, S. Cosi, E. Domnech 2012
Brief measures to screen for social phobia in primary care pediatrics K. A. Bailey, D. A. Chavira, M. T. Stein, M. B. Stein 2006
Preliminary validation of a screening tool for adolescent panic disorder in pediatric primary care clinics A. H. Queen, J. Ehrenreich-May, E. R. Hershorin 2012
Screening social phobia in adolescents from general population: the validity of the Social Phobia Inventory (SPIN) against a clinical interview K. Ranta, R. Kaltiala-Heino, P. Rantanen, M. T. Tuomisto, M. Marttunen 2007
The Mini-Social Phobia Inventory: psychometric properties in an adolescent general population sample K. Ranta, R. Kaltiala-Heino, P. Rantanen, M. Marttunen 2012
Use of the Chinese (Taiwan) version of the Social Phobia Inventory (SPIN) among early adolescents in rural areas: reliability and validity study C. F. Tsai, S. J. Wang, K. D. Juang, J. L. Fuh 2009
The Patient Health Questionnaire for Adolescents: Validation of an instrument for the assessment of mental disorders among adolescent primary care patients Johnson, Jeffrey G., Harris, Emily S., Spitzer, Robert L., Williams, Janet B. W. 2002
The utility of Screen for Child Anxiety Related Emotional Disorders (SCARED) as a tool for identifying children at high risk for prevalent anxiety disorders Muris, Peter, Merckelbach, Harald, Kindt, Merel, Bgels, Susan, Dreessen, Laura, van Dorp, Ciona, Habets, Andrea, Rosmuller, Sandra, Snieder, Nienke 2001
Diagnosis of depressed young peopleCriterion validity of WHO-5 and HSCL-6 in Denmark and Norway Christensen, Kaj S., Haugen, Wenche, Sirpal, Manjit K., Haavet, Ole Rikard 2015
The Beck Depression Inventory: Psychometric characteristics and usefulness in nonclinical adolescents Canals, Josepa, Blade, J., Carbajo, G., Domenech-Llaberia, E 2001
The CES-D as a screen for depression and other psychiatric disorders in adolescents Garrison, C. Z., Addy, C. L., Jackson, K. L., McKeown, R. E., Waller, J. L. 1991
A computerised screening instrument for adolescent depression: population-based validation and application to a two-phase case-control study Patton, G. C., Coffey, C., Posterino, M., Carlin, J. B., Wolfe, R., Bowes, G. 1999
Screening for adolescent depression: a comparison of depression scales Roberts, R. E., Lewinsohn, P. M., Seeley, J. R. 1991
Using the suicide risk screen to identify suicidal adolescents among potential high school dropouts Thompson, E. A., Eggert, L. L. 1999

Downloadable Data Content

  • XLSX Project Data