. Author manuscript; available in PMC: 2020 Aug 1.

Published in final edited form as: Child Psychiatry Hum Dev. 2019 Aug;50(4):647–660. doi: 10.1007/s10578-019-00869-6

Table 3.

“Stoplight” Recommendations Based on Different Screening Scenarios

Sample	Concurrent DLR	Prospective DLR	Post-test Probability	Interpretation
3^rd Grade Girls and Boys: Concurrent: 4.02%; Over Three Years:■ 13.5%
Moderate CDI-Y (8-14); Moderate CDI-P (5-11)	CDI-Y: 2.88 CDI-P: 1.49 Combined: 3.72	CDI-Y: 1.40 CDI-P: 1.45 Combined: 1.61	CDI-Y: Concurrent: 10.32% Prospective: 18.30% CDI-P: Concurrent: 5.62% Prospective: 18.83% Combined: Concurrent: 12.95% Prospective: 20.40%	Green: Despite DLRs above 1.00 for both parent and youth report, low base rates for girls and boys of this age suggest that it is still rather unlikely they are currently experiencing depression or will go on to experience depression. Specifically, 4 out of 5 youth with this profile will not go on to develop depression in the next 3 years.
6^th Grade boys: Concurrent: 4.13%; Over Three Years: 15.4%
High: CDI-Y (15+); Low CDI-P (0-4)	CDI-Y: 5.68 CDI-P: 0.60 Combined: 2.03	CDI-Y: 3.27 CDI-P: 0.64 Combined: 1.40	CDI-Y: Concurrent: 18.51% Prospective: 37.05% CDI-P: Concurrent: 2.34% Prospective: 10.33% Combined: Concurrent: 7.51% Prospective: 20.12%	Yellow: It is unlikely that boys with these scoring proflies are experiencing depression currently-despite the elevated DLR for the CDI-Y. However, the elevated CDI-Y should give one pause for prospective depressive episodes. Probably best to monitor symptoms in the immediate future, though a referral to outpatient mental health services may be premature absent any critical symptoms (i.e., suicidal thoughts).
6^th Grade girls: Concurrent: 9.03%; Over Three Years: 26.7%
Moderate CDI-Y (8-14), High P-CDI-P (12+)	CDI-Y: 2.88 CDI-P: 4.25 Combined: 5.07	CDI-Y: 1.40 CDI-P: 3.00 Combined: 5.14	CDI-Y: Concurrent: 22.36% Prospective: 34.23% CDI-P: Concurrent: 29.82% Prospective: 52.60% Combined: Concurrent: 33.64% Prospective: 65.53%	Red: Across parent and youth report, findings suggest an approximate 3-fold increase in the risk for currently having a depressive episode when compared to the base rate for this subsample. Even more concerning, approximately 2/3 of these girls will go on to develop a depressive episode in the next 3 years with this demographic and scoring profile. A referral for an assessment should be made.
9^th Grade Boys: Concurrent: 8.63%; Over Three Years: 31.4%
High CDI-Y (15+); Moderate CDI-P (5-11)	CDI-Y: 5.68 CDI-P: 1.49 Combined: 5.07	CDI-Y: 3.27 CDI-P: 1.45 Combined: 5.14	CDI-Y: Concurrent: 36.22% Prospective: 59.53% CDI-P: Concurrent: 12.97% Prospective: 39.48% Combined: Concurrent: 33.64% Prospective: 69.81%	Red: Similar to the profile described prior a referral should probably be made for this youth. The CDI-Y, the superior indicator for concurrent episodes, suggests a 4-fold increase in risk compared to the pre-test base rate. Furthermore, nearly 70% of youth with this demographic and scoring profile will experience an episode in the next 3 years.
9^th grade Girls: Concurrent: 17.16%; Over Three Years: 47.2%
Low CDI-Y (0-7); High P-CDI-P (12+)	CDI-Y: 0.59 CDI-P: 4.25 Combined: 2.03	CDI-Y: 0.64 CDI-P: 3.00 Combined: 1.40	CDI-Y: Concurrent: 10.55% Prospective: 36.29% CDI-P: Concurrent: 45.94% Prospective: 72.75% Combined: Concurrent: 28.87% Prospective: 55.47%	Yellow: Low CDI-Y suggest that a current episode is unlikely. Although the combined report suggests that over half of these youth will experience an episode this is only a slight increase from the pre-test base rate for this subsample. Elevated parent report suggests a considerable risk for a prospective episode warranting continued monitoring but not yet a referral.

Note: The following are a presentation of potentially challenging screening cases. Prevalence estimates derived from our sample for concurrent and prospective episodes are provided after describing demographic details (i.e., sex, grade) for each exemplar. DLR= (True positives within a specific scoring range/total number of positive cases)/(The number of false positives within a scoring range/total number of negative cases; [37]). DLRs are presented for both concurrent and prospective episodes. Post-test probability= (pre-test odds x DLR)/(pre-test odds x DLR+1); Interpretation=Decision making based on post-test probability; Green=No action; Yellow=Monitor; Red=Refer for assessment. CDI-Y=Children’s Depressive Inventory (CDI; [30])-Youth Report; CDI-P=CDI-Parent Report; Combined=Predictive Probabilities of CDI-Y and CDI-P predicting depressive episodes; Low, Moderate, High=CDI scoring categories derived from Table 2.