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Effectiveness of the Birleson Depression Self-Rating Scale (DSRS) in screening for depression in vulnerable young males with severe emotional and behaviour difficulties in a residential setting

Colin Martin, Denise Carroll, Tim Duffy


Depression in Looked After and Accommodated Children (LAAC) has been observed as being higher than in adolescents in the general population. The Birleson assessment instrument is frequently used to assess depression in young people. The focus of this paper is the evaluation of the effectiveness of the Birleson depression self-rating scale as an effective screening instrument for depression in adolescent males with emotional, behavioural, educational and social difficulties. One hundred and eighty-one participants from a Scottish residential centre (The Centre) for young males with severe emotional and behavioural difficulties participated in the study. The young people at the Centre consisted of 3 distinct groups: day pupils, residential and secure care (looked after and accommodated young people). As part of the admission process they completed the Birleson Depression Self-Rating Scale (DSRS) and also the standard professional approved Scottish LAAC health assessment. The analysis in this study showed that young people in secure care had a significantly higher level of depression than those in day care, as measured by the Birleson DSRS. Within the LAAC population at the Centre, a comparison of the Birleson DSRS detection rates for depression was made with findings from the standard health assessment. Prior to admission, 3% of the young people (n=6) at the centre had a previous clinical diagnosis of depression. The Birleson DSRS failed to identify 4 out of these 6 young people. The standard LAAC health assessment identified that 15% of LAAC (n=26) had current suicidal ideation/behaviours. Of the young people at the Centre who had current suicidal behaviours, the Birleson DSRS did not identify 27% of them. This raises concerns about the sensitivity of the Birleson DSRS to identify depression in this vulnerable population.


Behavioural difficulties, Birleson Depression Self-Rating Scale (DSRS), depression, depression screening, Looked After and Accomodated Children (LAAC), patient-centered care, person-centered psychiatry, residential setting

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