Child Behavior Checklist May Predict Major Depressive Disorder in Children

Mental health professional taking notes
Mental health professional taking notes
Investigators examine the predictive utility of the subsyndromal Child Behavior Checklist anxiety and depression score for detecting MDD 10 years later.

The Child Behavior Checklist has demonstrated predictive power for identifying children with subsyndromal symptoms at risk for major depressive disorder, according to a study published in The Journal of Pediatrics.

Participants in this study were originally recruited to take part in a longitudinal study of youth with and without attention-deficit hyperactivity disorder, as well as their immediate family, for a 10-year follow-up. Those included in the study did not have major depressive disorder or attention deficit hyperactivity disorder at baseline. The cohort was divided into 4 groups: normal controls, subsyndromal major depressive disorder, high risk, and high risk + subsyndromal major depressive disorder. Factors included in the high-risk assessment included parental mood disorders.

This study included 537 children aged 6 to 17 years, 402 of whom completed the 10- or 11-year follow-up. At the 10-year follow-up, the greatest risk for major depressive disorder was observed in the 22 children whose parents had mood disorders and who had scores on the Child Behavior Checklist subsyndromal scores for anxiety and/or depression. Subsyndromal scores on the Child Behavior Checklist alone was associated with intermediate outcomes, as did mood disorders of parents. Global assessment of functioning scores did not differ significantly between groups at follow-up (P =.004).

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The study researchers conclude that “subsyndromal symptoms of major depressive disorder indexed through subsyndromal scores of the [Child Behavior Checklist] anxiety/depression subscale have predictive utility in identifying children at great risk for developing major depressive disorder, anxiety disorders, and associated impairments within and without the context of genetic risk for major depressive disorder. If confirmed, this observation could have very significant clinical and public health implications in the identification of children at the highest risk for the development of major depressive disorder.”


Uchida M, Fitzgerald M, Woodworth H, Carrellas N, Kelberman C, Biederman J. Subsyndromal manifestations of depression in children predict the development of major depressionJ Pediatr. 2018 Oct;201:252-258.e1.