Kutcher Adolescent Depression Scale KADS-11
Kutcher Adolescent Depression Scale KADS-11 overview
Creator and Context
The Kutcher Adolescent Depression Scale, 11 item version (KADS-11) is a self report measure of depression in adolescents, designed for monitoring rather than screening.
It was developed by Stan Kutcher and colleagues, with the KADS family originating in work by LeBlanc, Almudevar, Brooks and Kutcher in 2002. The KADS-11 is optimised for monitoring outcome in adolescents receiving treatment for major depressive disorder.
Presenting Conditions
The 11 items cover low mood, worry, tiredness, physical restlessness, self worth, sleep, concentration, appetite and outlook.
Item 11 is a suicidality item, with anchors ranging from no thoughts, plans or actions through to plans or actions that have caused harm. It requires a risk response pathway wherever the measure is used.
Administration
Self administered. The young person rates how they have been on average over the last week. Items 1 to 10 are rated from Hardly Ever (0) to All of The Time (3). Item 11 uses its own graded anchors.
Desired Audience
Adolescents aged 12 to 17. The publisher describes the KADS-11 as optimised for monitoring outcome in adolescents receiving treatment for major depressive disorder.
The KADS-11 was built to answer one question: is this young person getting better on treatment. It is short enough to run at every review, and its evidence base comes from an eight week controlled treatment trial, which is exactly the use case it serves.
Considerations
The KADS-11 has no validated cut off and no severity bands. The official scoring guidance states that all scores should be assessed relative to the individual's own baseline, with higher scores indicating worsening and lower scores suggesting improvement.
The frequently quoted cut off of 6 belongs to the six item KADS, not the KADS-11. If you need an adolescent screening threshold, use the KADS-6.
Items 9 and 10 cover anxiety and somatic worry, so the total is not purely depressive.
Item 11 is a suicidality item and requires an escalation protocol on any non zero response.
The scale is copyright Stan Kutcher and freely downloadable, but commercial redistribution should be confirmed with the copyright holder.
How to score the Kutcher Adolescent Depression Scale KADS-11
Conducting the assessment
The young person rates 11 items for the last week, giving a total from 0 to 33.
Interpretation
Items are summed to give a total from 0 to 33.
There are no validated diagnostic categories associated with particular ranges of scores. Interpretation is relative to the individual's baseline: higher scores indicate worsening depression and lower scores suggest possible improvement.
For screening rather than monitoring, the six item KADS uses a cut off of 6, which achieved sensitivity of 92 percent and specificity of 71 percent against a structured diagnostic interview.
Clinical Considerations
Do not apply a cut off. Track the trajectory from baseline.
Have a clear escalation pathway for item 11 before deploying it digitally.
Use the KADS-6 if what you actually need is a screening threshold.
Kutcher Adolescent Depression Scale KADS-11 use cases
Monitoring depression outcome in adolescents during treatment
Tracking symptom change against a young person's own baseline
Research in adolescent depression
Category
Depression
Research Summary
LeBlanc, J. C., Almudevar, A., Brooks, S. J., & Kutcher, S. (2002). Screening for adolescent depression: Comparison of the Kutcher Adolescent Depression Scale with the Beck Depression Inventory. Journal of Child and Adolescent Psychopharmacology, 12(2), 113 to 126.
Brooks, S. J., Krulewicz, S. P., & Kutcher, S. (2003). The Kutcher Adolescent Depression Scale: Assessment of its evaluative properties over the course of an 8 week pediatric pharmacotherapy trial. Journal of Child and Adolescent Psychopharmacology, 13(3), 337 to 349.
Lipps, G., Lowe, G. A., De La Haye, W., et al. (2018). Validation of the Kutcher Adolescent Depression Scale in a Caribbean student sample. CMAJ Open, 6(3), E248 to E253.
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Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
