An integrative review of adolescent depression screening instruments: applicability for use by school nurses

Background: Major depression is a significant yet underdiagnosed problem of adolescence. The consequences of undiagnosed and untreated depression in this vulnerable population can have detrimental effects. School nurses are in a prime position to perform early screening and referral. However, the school environment requires special consideration as the setting for screening of adolescent depression.

Objective: The purpose of this paper is to identify instruments that can be utilized by the school nurse to perform easily administered, rapid adolescent depression screenings that are valid, reliable, and economical.

Methods: An integrative review of current depression instruments used in adolescents was conducted.

Results: Of the seven most commonly used instruments, only four of those fit the criteria listed for conducting screening in the school setting by the school nurse. The four instruments include the Beck Depression Inventory-Youth (BDI-Y), the Children's Depression Inventory, the Center for Epidemiological Studies-Depression Scale for Children, and the Reynolds Adolescent Depression Scale.

Conclusion: Although all four of the identified instruments provide reliability and validity in the school setting, it is the other criteria: affordability, ease of administration, and the ability of the instrument to be rapidly scored, that placed the Center for Epidemiological Studies-Depression Scale for Children and the BDI-Y as the reasonable choice of instruments for use by the school nurse.