Learning Objective #1: using operating characteristics to judge which scale is superior to the others in diagnosing depressive disorders.

Learning Objective #2: determine optimal cutoff points for discriminating between subjects with and without depressive disorders.

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Depressive symptoms occur in 24.1% of college students in Taiwan, with a higher prevalence among freshmen. To determine the best screening instrument for depressive symptoms among college freshmen, this study compared the validities of the Taiwanese Depression Questionnaire (TDQ), Beck Depression Inventory II (BDI-II), and the Center for Epidemiologic Studies-Depression Scale (CES-D).A randomized sample of 172 college freshmen completed 3 depression-screening questionnaires and was assessed by psychiatrists using the Mini International Neuropsychiatric Interview (MINI) based on DSM-IV diagnostic criteria. Criterion validity and receiver operation characteristics were determined for the 3 scales. The point and lifetime prevalences of depression determined by the MINI in this sample of college freshmen were 2.33% and 4.65%, respectively. The TDQ showed excellent internal consistency (.91), convergent validity (.83), strong correlation with DSM-IV depression diagnostic criteria (effect size r=.3870), and operating characteristics (areas under the curve were .97). All 3 scales had cutoff points for screening depression of 1.0. Corresponding specificities were .89 (TDQ), .86 (BDI-II), and .65 (CES-D); overall accuracies were .89 (TDQ), .87 (BDI-II), and .66 (CES-D).Only 4 cases of depression were diagnosed by psychiatrists according to DSM-IV criteria, limiting analysis of screening ability for different diagnoses of depression. The TDQ was the most accurate screening tool in terms of matching DSM-IV diagnostic criteria and indices of quality in screening tools. The short completion time, safety, low cost, and simplicity of the TDQ make it a valid tool for screening depression among college students in Taiwan.