Journal of Psychiatric Practice Vol. 16, No. 4 July 2010 217 Major depressive disorder (MDD) is one of the most prevalent, commonly diagnosed, and life-altering mental illnesses that affects children and adoles- cents. 1 The prevalence of depression is particularly troubling due to the early manifestation and invasive nature of depressive symptoms during childhood and adolescence and the chronic nature of the disorder, which can result in life-long functional and social impairments, such as an increased risk of suicidality, academic and personal difficulties, and substance abuse. 1,2 As a result of the growing concern about childhood and adolescent depression, a significant line of research has been established to examine safe, efficacious, evidence-based antidepressant treat- ments. Research has supported the efficacy of three primary treatments for childhood and adolescent depression: medicine, psychotherapy, or a combina- tion of both treatments, which are differentially implemented based on symptom severity. 3–9 For example, in children and adolescents, SSRIs are typ- ically indicated only for the treatment of moderate to severe MDD. Although these treatments have been successful in treating depression, a significant num- ber of children and adolescents experience relapse and continue to struggle with depressive symp- toms. 3,4 In order to further address and ultimately reduce the significant impairments associated with Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders affecting chil- dren and adolescents. The significant psychiatric, social, and functional impairments associated with this disorder coupled with the high incidence of relapse indicate a need for continued efforts to enhance treatment. Current empirically supported treatments for childhood and adolescent MDD include psychotropic medications, psychotherapy, and a combination of both treatments, with selec- tion of the most appropriate strategy depending on symptom severity. One strategy to enhance treatment outcome is the use of measurement-based care. This article provides a systematic review of measurement-based care in the treatment of childhood and adolescent MDD. It also presents a comprehensive analysis of widely used depression rating scales and discusses their utility in clini- cal practice. This review found evidence supporting the utility and benefit of depression rating scales to document depression severity in children and adolescents. We also found evidence sug- gesting that many of these scales are time efficient, and that both clinician-rated and self-rated scales provide accurate assessment of depressive symptomatology. Future research is warranted to examine the utility of measurement-based care in clinical practice with child and adolescent popu- lations. (Journal of Psychiatric Practice 2010;16:217–234) KEY WORDS: major depressive disorder, child, adolescent, measurement-based care, symptom severity, child depression rating scale JOANNA M. ELMQUIST TABATHA K. MELTON PAUL CROARKIN, DO SHAWN M. McCLINTOCK, PhD ELMQUIST, MELTON, and CROARKIN: University of Texas Southwestern Medical Center, Dallas; McCLINTOCK: Univer- sity of Texas Southwestern Medical Center and New York State Psychiatric Institute, Columbia University. Copyright ©2010 Lippincott Williams & Wilkins Inc. Please send correspondence to: Shawn M. McClintock, PhD, UT Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75235-8898. Shawn.mcclintock@utsouthwestern.edu Acknowledgments: This publication was supported by Grant Number KL2 RR024983 (PI: Milton Packer) from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and Grant Number R25 MH74675 (PI: Graham Emslie) from the National Institute of Mental Health (NIMH). The authors declare no conflicts of interest. A Systematic Overview of Measurement-Based Care in the Treatment of Childhood and Adolescent Depression