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Background and Purpose: Few instruments have been established as valid and reliable to screen for depression among Arab adolescents. The purpose of this study was to examine and compare the performance of two of the most widely used depression screening instruments, the Beck Depression Inventory‐II (BDI‐II) and the Center for Epidemiologic Studies‐Depression scale (CES‐D), with Arab adolescents. Methods: A nationwide school survey was conducted in Jordan. A total of 3,292 adolescents (1,766 females; 54%) aged 13–17 years completed and returned the survey that included the BDI‐II, CES‐D, sociodemographics, and health information. Comparisons were made between the BDI‐II and CES‐D on internal consistency and the reported prevalence of depression in the whole population and subgroups. Multivariate ordinary least squares and logistic regressions were used to assess factors associated with adolescent depression. Agreement regarding recommended cutoffs was also examined using Cohen's k. Results: Depression prevalence was significantly higher with the CES‐D compared to the BDI‐II among the same set of sample subgroups. Depression scores from both instruments showed different statistical associations with established risk factors for adolescent depression. The two instruments showed a moderate agreement (kappa = 0.55), indicating that the instruments do not completely identify the same cases. Different cutoff scores of the CES‐D seemed to perform better for different age groups. Conclusions: Our results varied systematically as a function of the measure used to identify depression prevalence. Caution in the interpretation of associations of depression scores with risk factors is required, as associations may be measurement artifacts. However, given the limited availability of mental health care resources in Arab countries, screening instruments like the BDI‐II and CES‐D may be a critical first step in preliminarily identifying cases, albeit neither can replace the clinical interview. We cautiously recommend using the CES‐D with the risk of over diagnosing, but with the benefit of finding issues which are not typically addressed when there is a lack of mental health services. With the growing social and political unrest in Arab countries, increasing depression rates over time is expected to be a major public health issue. Methodical consideration for how to invest in community‐based screening is warranted. [ABSTRACT FROM AUTHOR]

Having valid, reliable, and culturally adapted tools to screen for adolescent depression is a crucial concern for mental health care professionals who promote preventive care. To this aim, this study tested the psychometric properties and factor structure of the Center for Epidemiologic Studies Depression (CES-D) Scale among Arab adolescents. A nationally representative sample of 3,292 Jordanian adolescents aged 13-17 completed the CES-D 20-item scale. A principal axis factoring with a varimax rotation was used to identify the factor structure of the scale on a half of the sample ( n 1  = 1,655), followed by a confirmatory factor analysis to assess the fitness of the factor structure to the other half of the sample ( n 2  = 1,637) on a variety of model-fit indices. Findings did not support the original four-factor structure. The results indicated that two factors provide a reasonably better fit: Factor 1 combined items on depressed affect, somatic complaints and interpersonal problems, and Factor 2 consisted of the remaining four positive affect items. The modified model showed high internal reliability and excellent construct validity. The results revealed that depression construct among Arab adolescents, as measured by the CES-D, differs from that in other ethnic groups. Nurses and other health professionals need to closely examine the different presentation of depressive symptoms across racial and ethnic groups to avoid diagnostic errors, inappropriate management, and poor compliance.