Common Mental Disorders Depression - New Zealand Doctor

The relevant evidence comprised six systematic reviews 66,176,182,218-220 and 32 primary
studies (some of which were included in the systematic reviews), which evaluated a
total of 12 different assessment tools. Tools for which evidence of effectiveness was
found are discussed in the following section. The evidence relating to the effectiveness
of these tools is also discussed in the following section. Further details of other studies
and tools evaluated can be found in evidence tables (4a–c) on the NZGG website
(http://www.nzgg.org.nz).
Overall mental health
There is evidence that both the Pediatric Symptom Checklist (PSC) 221-225 and the
SDQ 226-235 are valid and feasible for assessing child and adolescent mental health
problems from 4 years of age. The PSC and the SDQ can be completed within
5 minutes by a young person or their parent and/or teacher. Among adolescents,
the SDQ is reasonably reliable for detecting depressive disorders, conduct disorder,
ADHD disorders, and some anxiety disorders (social phobia, post-traumatic stress
disorder, obsessive compulsive disorder and generalised anxiety disorder). 226
However, the SDQ has been shown to identify fewer than 50% of adolescents with
specific phobias, separation anxiety, panic disorders and eating disorders. 226 Parent
and teacher responses on the SDQ were noted to be better predictors of disorder than
self-reporting. 226-231,233-235 There was some limited evidence that the SDQ is sensitive
to change. 232 No evidence was found on sensitivity to change in mental health with
respect to the PSC. Overall the SDQ appeared the most robust tool for assessing
overall mental health and monitoring response to treatment in young people.
Depression
The SMFQ is valid as a screen for depression, though there is limited evidence on
sensitivity to change. 66,176,236-238 The RADS is designed to measure the severity of
depressive symptoms. It has acceptable validity, feasibility and sensitivity to change,
and has been tested in New Zealand populations. 66,219,239 However, there is a fee
for use of the RADS.
Anxiety
The systematic review of the literature found no brief anxiety screening tools that
were well-validated for use in primary care. The brief Multidimensional Anxiety Scale
for Children (MASC-10) 240 is a short version of a longer empirically-derived tool but
there is insufficient evidence to support use of the short version. There is a fee for use
of this instrument.
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Identification of Common Mental Disorders and Management of Depression in Primary Care