CHILDREN’S DEPRESSION RATING SCALE (CDRS)
CHILDREN’S DEPRESSION RATING SCALE (CDRS)
The Children’s Depression Rating Scale (CDRS) is a 16-item measure used to determine the severity of depression in children 6-12 years of age.
Items are measured on 3-, 4-, 5-, and 6-point scales. The CDRS is derived from the Hamilton Rating Scale for Depression (HAM-D); a score of 15
on the CDRS is equivalent to a score of 0 on the HAM-D. Assessment information is based on parent, child and schoolteacher interviews.
1. Depressed Mood (0-5). Affect may be aroused (e.g., sad, forlorn, 5. Suicide and Suicide Ideation (0-5).
gloomy, anguished) or suppressed. Note nonverbal behavior (e.g.,
facial expression, eye contact, body posture). Child may or may not 0=No information
verbalize feelings of sadness.
2=Has thoughts about suicide-usually when angry
1=Definitely not depressed-facial expression and voice animated
during interview 3=Recurrent thoughts of suicide
2=Doubtful-mild suppression of affect during interview and/or some 4=Thinks about suicide and names methods or if depressed,
loss of spontaneity strongly denies thinking about suicide
3=Mild-overall some loss of spontaneity. Child looks unhappy 5=Suicide attempt within the last month or actively suicidal
during parts of interview. May still be able to smile when discussing 6. Irritability (0-5). Information usually from Parents, nurses, etc.,
nonthreatening areas and direct observation. This can range from whining, “chip on the
shoulder” attitudes to temper outbursts and other direct displays of
4=Moderate-may have a moderate restriction of affect throughout hostility and anger. Rate on frequency of irritable behavior. Some
most of the interview and have brief periods where looks unhappy children may directly display whining, irritable behavior during the
5=Severe-child looks sad, withdrawn with little verbal interaction
throughout interview. May look like crying 0=No information
2. Weeping (0-3). Information usually from parents, teachers, but
occasionally from child. 1=Normal
0=No information 2=Occasional-slightly more than normal
1=Normal for age 3=Episodic
2=Suggestive statements that child cries more frequently than 4=Frequent
3=Cries frequently-more than reasonable for age or provocation 7. Schoolwork (0-5). Consider current function as opposed to usual
3. Self-Esteem (0-5). The child’s ability to describe self is very or expected function. Expected function should take into
concrete at 6 and 7, becoming more sophisticated at 9 and 10. consideration the intelligence of the child and specific learning
Note affective tones around the child’s responses. Inappropriate disabilities, cultural and family expectations.
guilt rates 3 or 4.
1=Performing at or above the expected level.
1=Child describes self in mostly positive terms
3=”Not working to capacity” or recent disinterest in schoolwork with
2=Doubtful evidence of lowered self-esteem minimal interference with performance
3=Child describes self using a mixture of attributes, with both 4=Doing poorly in most subjects or evidence of a recent major
affectively positive and negative tones interference with performance
4=Child uses both affectively positive and negative terms, but 5=Incapable of doing productive schoolwork at time of rating
preponderance of negative attributes, or if concept understood, 8. Capacity to have fun (0-5). Often reflected in hobbies and
gives minimal bland answers interests outside of school.
5=Child either refers to self in derogatory terms (e.g., unpleasant 0=No information
nicknames) or completely avoids any question dealing with self-
concepts, self-image, or self-esteem 1=Child’s interests and hobbies appropriate for age, personality,
4. Morbid Ideation (0-4). and environment. No appreciable change during present illness
0=No information 2=Child has interests-hobbies outside of school, but activities
mainly passive. Shows some interest but not enthusiasm
3=Child easily bored. May frequently complain of nothing to do or
2=Some morbid thoughts-all related to a recent reality event child expresses interest and hobbies which are realistically
unavailable to the child
3=Admits to morbid thoughts on questioning, but does not dwell on
them, or parents report morbid thoughts of child 4=In structured activities, may “go through the motions” without
real interest or enthusiasm
4=Death themes spontaneously discussed or elaborate and
extensive morbid ideation 5=Child doesn’t take initiative to involve self in any activities. Tends
to passively watch others or watch TV. Takes pushing and coaxing
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9. Social withdrawal (0-5). 12. Disturbance of Eating Pattern (0-3).
0=No information 0=No information
1=Enjoys good friendships with peers at school and home or never 1=No problem
has had adequate peer relationships
2=Mild. Mother complains of change in eating pattern or chronic
2=Child names several friends, but relationships sound meager or problems with food, either some variety of “poor eater” or overeats
has one or two friends, but not able to integrate into larger peer
group 3=Moderate. More severe disturbance of eating pattern. If
undereats, accompanied by weight loss. If overeats, has moderate
3=Child changes from actively seeking out friendships to a passive obesity. May steal and hoard food or show more bizarre pattern
role (i.e., waits for others to initiate a relationship). Observes rather such as eating out of garbage cans. Unable to follow a medically
than participates in groups unless pushed necessary diet prescribed by a physician
13. Frequent Physical Complaints (0-4). Child may complain of
4=Child frequently rejects opportunities for seemingly desirable
stomach pains, headaches, or other bodily aches and pains. Rate
interaction with other children
frequency. Parents and nurses generally more reliable.
5=Child does not relate to other children. Either states he has “no
friends” or actively rejects former friends and any new children
10. Expressive Communication (0-3). Refers primarily to possible 1=No complaints
psychomotor retardation of language. Rate on the quantity and
quality of verbal material. Consider the cultural background and 2=Occasional complaints. Child is easily reassured
intelligence of the child in the interview situation
3=Frequent complaints, but can be distracted or reassured (e.g.,
0=No information school phobic who feels fine if allowed to stay home from school)
1=Normal 4-Preoccupied with aches and pains, may keep child from other
2=Doubtful-mild. Monotonous voice. Mild delay in answering
questions. Gives monosyllabic or short answers in all areas of 14. General Somatic (0-3).
3=Moderate-severe. Same as (1) except delay in answering
questions prolongs the interview. Even greater reduction in verbal 1=Normal
content, may also have poverty of facial expression
2=Occasional complaints of fatigue
11. Sleep (0-3). This information usually most reliable from child
interview. 3-Frequent-complains of being tired, doesn’t feel like doing things
used to enjoy
0=No information 15. Hypoactivity (0-3). Consider current activity level as opposed to
usual activity level. Check with parents, school teachers, nurses
1=No difficulty or occasional difficulty sleeping
2=Mild-frequent difficulty sleeping. Child and/or parent may report
this 1=Activity at usual level
3=Moderate-difficulty with sleeping nearly every night. May be 2=Minimal retardation activity
evidence of sleep deprivation (e.g., child looks tired)
3=Talks slowly, walks slowly, slow to move during play
Circle if difficulty with sleep is:
16. Reversal of Affect (0-2).
0=No information/does not apply
3=Early morning wakening
Source: Trends in Evidence-Based Neuropsychiatry, January/February 2003
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