Revised Child Anxiety Depression Scale (RCADS) Scores in Child and Adolescent Patients at Intake: Gender, Ethnicity and Diagnostic Differences in Urban Youth

Szimonetta Mulati, PhD, MS

Boston Children’s Hospital – Fellow

Scientific Abstract

Background: Anxiety and depressive disorders are highly prevalent psychiatric conditions in youth. Psychometrically strong measures exist but relatively little is known about several important variables. Therefore, this study explores whether the total Revised Child Anxiety and Depression Scale (RCADS) score varies as a function of group differences (age, gender, ethnicity, diagnosis type) in children and adolescents presenting to an outpatient clinic in an urban setting.

Methods: This is a secondary data analysis conducted via an archival chart review of 247 children and adolescents  (M=13.8 years, SD=2.7). As part of the clinical intake practices, patients completed the RCADS, Strengths and Difficulties Questionnaire (SDQ) and Pediatric Symptom Checklist (PSC-35). Test, demographic, and diagnostic data was extracted anonymously from the EMR. Preliminary testing (t-tests and ANOVAs) was employed to determine differences in intake scores across group variables. Multiple regression analyses were used to examine which factors are significant predictors. Pearson correlations between the RCADS and SDQ and PSC-35 were used to examine convergent validity.

Results: Females (M= 29.6, SD= 15.2) scored significantly higher than males (M= 20.6, SD= 14.6) on the RCADS, suggesting that females endorsed greater number and severity of anxiety and depression symptoms compared to males (t(245)= 4.6, p < .001). Youth with internalizing disorders (M=27.5, SD=15.5) also scored significantly higher compared to those with externalizing disorders (M=17.5, SD= 12.9), (t(243)=3.6, p<.001). However, there were no significant differences by age or ethnicity. Gender (B = -7.6, SE = 1.9, p < .001) and diagnosis type (B=-8.7, SE= 2.6, p = .001) were the only significant predictors in the multiple regression model with age and ethnicity included. The total RCADS score was significantly and positively correlated with the Internalizing Problems subscales for both the SDQ (r(211) = .71, p <.001) and PSC-35 (r(129) = .75, p <.001), suggesting sound convergent validity.

Conclusion: The findings emphasize the clinical utility of the RCADS measure in clinical practice and align precisely with the conference theme of advancing research that enhances the well-being of young patients.

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research Areas


Szimonetta Mulati, PhD, Robert D. Friedberg, PhD, Alinne Barrera PhD, Eduardo Bunge PhD, Thomas Tarshis MD

Principal Investigator

Robert D. Friedberg, PhD