Quick Guide to the

Revised Children’s
Anxiety and Depression
Scale (RCADS)
What is the RCADS and what does it measure? The RCADS:
• Is a self-report questionnaire that assesses symptoms of depression and anxiety
in children and adolescents.

• Captures symptoms related to:

major depressive disorder (MDD) generalized anxiety disorder (GAD)

panic disorder separation anxiety disorder (SAD)

social phobia obsessive-compulsive disorder (OCD)

• Comes in different versions:

Child Version Parent Version

RCADS-25 (short version)

RCADS-47 (long version)

Who is the RCADS for?

• Children and adolescents 8–18 years old.

How is the RCADS administered? It is:

• Completed by children and adolescents
with at least a third-grade reading level.

• Completed by parents (using the RCADS-P)

when children are too young (< 8 years-old)
or developmentally unable to complete the
measure themselves, or when a complementary
carer perspective would be helpful.

• Completed using paper and pencil or integrated

into electronic systems
(e.g., tablet, electronic medical record).

How can I access the RCADS?

• Go to the Child FIRST Lab’s website1.

1
https://www.childfirst.ucla.edu/resources/

© 2021 CAMH. To obtain permission to reproduce any part of this material, please contact 1
the Cundill Centre for Child and Youth Depression at cundill.centre@camh.ca. CAMH
is fully affiliated with the University of Toronto, and is a Pan American Health Organization.
Why use the RCADS? Because it is:
• Free for non-commercial use.

• Validated.

• Developed specifically for children and youth.

• Able to assess both anxiety and depression symptoms, which often occur together.

• Able to capture both youth and parent perspectives on symptoms.

• Able to help you make treatment decisions by showing you whether symptoms are changing over
time (when you use the RCADS at multiple time points) — this is called measurement-based care.

What are the differences between the long and short versions?
Long version (RCADS-47)

• Most widely used and validated version of the RCADS.

• Consists of 47 items.

• Can be broken down into six subscales.

• Completion time: 10–15 minutes.

Subscales # of Items Scores Scoring System

Depression MDD 10 MDD Score Overall depression score

Anxiety OCD 6 OCD Score

Total internalizing score
Social Phobia 9 Social Phobia
Score

SAD 7 SAD Score Overall anxiety score

Panic Disorder 9 Panic Disorder

Score

GAD 6 GAD Score

Short version (RCADS-25)

• A 25-item version has been developed to reduce the

Note: it is not possible to report separate
burden on respondents and speed up completion time. summary scores for the 5 specific anxiety
disorders in the short version.
• Completion time: 5–10 minutes.

Subscales # of Items Scoring System

Depression MDD 10 Overall depression score

Anxiety OCD 3
Total internalizing score
Social Phobia 3

SAD 3 Overall anxiety score

Panic Disorder 3

GAD 3

© 2021 CAMH. To obtain permission to reproduce any part of this material, please contact 2
the Cundill Centre for Child and Youth Depression at cundill.centre@camh.ca. CAMH
is fully affiliated with the University of Toronto, and is a Pan American Health Organization.
What does the RCADS NOT capture?
suicidal thoughts or behavior selective mutism post-traumatic stress

bipolar disorder substance use disorder trauma

any other disorders that are not directly related to depression and anxiety

What does the RCADS look like?

Date: ____________ Name/ID: ___________________

RCADS

Please put a circle around the word that shows how often each of these things happens to you. There are no
right or wrong answers.

1. I worry about things Never Sometimes Often Always

2. I feel sad or empty Never Sometimes Often Always

3. When I have a problem, I get a funny feeling in my
Never Sometimes Often Always
stomach
4. I worry when I think I have done poorly at something Never Sometimes Often Always

5. I would feel afraid of being on my own at home Never Sometimes Often Always

6. Nothing is much fun anymore Never Sometimes Often Always

7. I feel scared when I have to take a test Never Sometimes Often Always

8. I feel worried when I think someone is angry with me Never Sometimes Often Always

How
9. I is
worrythe RCADS
about being scored?
away from my parents Never Sometimes Often Always
10. I get bothered by bad or silly thoughts or pictures in my
• Step
mind1: Score each response as 0 (never), 1 (sometimes), 2 (often), or 3 (always).
Never Sometimes Often Always

11. I have trouble sleeping Never Sometimes Often Always

• Step 2: Sum the response values for each subscale.
12. I worry that I will do badly at my school work Never Sometimes Often Always

• Step 3:that
13. I worry
my family
Convert
something awfulthis raw tosummary
will happen someone in score
Never into a standardized
Sometimes Often Always

“T-score”
14. I suddenly feelfor
as if Ithe appropriate
can't breathe when there is no gender and grade level with the
Never Sometimes Often Always
reason for this
help of a conversion table (available
15. I have problems with my appetite
fromSometimes
Never
the ChildOften
First Lab).
Always

• Step (like 4:
16. I have to keep checking that I have done things right
Interpret
the switch is off, or thethe
door isT-score
locked) with reference
Never to clinical
Sometimes Often cut-offs
Always

(see box
17. I feel scaredbelow).
if I have to sleep on my own Never Sometimes Often Always
18. I have trouble going to school in the mornings because I
• Scoring can
feel nervous be done manually, via programs
or afraid
Never
provided
Sometimes Often
by the
Always

developers
19. I have no energy for(in Excel or statistical software),
things Never or automatically
Sometimes Often Always

if20.the
I worryRCADS is integrated into electronic
I might look foolish Never systems. Often
Sometimes Always

21. I am tired a lot Never Sometimes Often Always

Clinical Cut-Off T-scores
22. I worry that bad things will happen to me Never Sometimes Often Always

Clinical cut-off scores can help determine next steps in the young
Page 1 © 1998 Bruce F. Chorpita and Susan H. Spence – For terms of use, see User’s Guide at www.childfirst.ucla.edu/resources/

person’s treatment plan.

T-score Meaning Clinical Implication

T-score below 65 Normal range No referral to treatment indicated, unless clinical

judgment suggests otherwise

T-score between Borderline clinical range Clarify need for referral by doing a more thorough
65 and 69 assessment or by using clinical judgment
Only 6% of youth in the general
population have T-scores of 65 or higher.

T-score 70 Clinical range Referral to treatment indicated

or above
Only 2% of youth in the general
population have T-scores of 70 or higher.

© 2021 CAMH. To obtain permission to reproduce any part of this material, please contact 3
the Cundill Centre for Child and Youth Depression at cundill.centre@camh.ca. CAMH
is fully affiliated with the University of Toronto, and is a Pan American Health Organization.
How can I define outcomes based on the RCADS?
As always, use clinical judgment to help make sense of the information you gather from
structured questionnaires. Consider risk of self-harm or suicide, trauma, and the young
person’s support system and ability to function.

The following chart suggests a way of calculating indicators of change based on

RCADS scores — note that there is no consensus on these definitions at the moment.

Definition
Outcome
Score change on the RCADS Time frame

Response Meaningful improvement; for example, at least a 50% Following the start of treatment
reduction in the raw score (or at least a 25% reduction and lasting for at least 2 weeks
in youth with treatment resistant depression)

Remission T-score below 65 Lasting for a period of at least

3 weeks up to 4 months

Recovery T-score below 65 Lasting for at least 4 months

after the onset of remission

Relapse T-score rises to 70 or above During the remission period

Recurrence T-score rises to 70 or above During the recovery period

Note: Outcome definitions

guided by Rush et al. (2006)
Is the RCADS valid and reliable?
• It has been used with children and youth in at least 25 countries across Africa, Europe,
North America, South America, and Asia.

• Research suggests the RCADS-47 questions are effective indicators of depression and
anxiety symptoms (i.e., the scale has “internal consistency” and “construct validity”).

• Research suggests the RCADS-47 reliably provides similar results when administered
at different time points (“test-retest reliability”).

• There is some evidence that the RCADS can pick up change in symptoms over time.

• The RCADS-25 has been less widely validated, but existing results are promising.

© 2021 CAMH. To obtain permission to reproduce any part of this material, please contact 4
the Cundill Centre for Child and Youth Depression at cundill.centre@camh.ca. CAMH
is fully affiliated with the University of Toronto, and is a Pan American Health Organization.
What languages are available?
• Several—download different versions from the Child FIRST Lab’s website2.

RCADS-47 (18 languages) RCADS-25 (5 languages)

US English, Chinese, Danish, Dutch, Finnish, French, German, US English, Hindi, Spanish, Finnish, Swedish
Greek, Icelandic, Korean, Norwegian, Persian, Polish, Slovene,
Portuguese, Spanish, Swedish, Urdu

Where can I access additional resources?

The RCADS user guide and scoring tools can be found on the Child FIRST Lab’s website3.

Key references
Chorpita, B. F., Moffitt, C., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical
sample. Behaviour Research and Therapy, 43, 309-322.

Chorpita, B. F., Yim, L. M., Moffitt, C. E., Umemoto L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and
depression in children: A Revised Child Anxiety and Depression Scale. Behaviour Research and Therapy, 38, 835-855

Ebesutani, C., Korathu-Larson, P., Nakamura, B., Higa-McMillan, C., and Chorpita, B. (2017). The Revised Child Anxiety and
Depression Scale 25-Parent Version: Scale Development and Validation in a School-Based and Clinical Sample. Assessment, 24(6),
712-728

Ebesutani, C., Reise, S. P., Chorpita, B. F., Ale, C., Regan, J., Young, J., Higa-McMillan, C., & Weisz, J. R. (2012). The revised child
anxiety and depression scale short version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor.
Psychological Assessment, 24, 833–45

Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally
important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61(2), 102–109.

Rush, A. J., Kraemer, H. C., Sackeim, H. A., Fava, M., Trivedi, M. H., Frank, E., Ninan, P. T., Thase, M. E., Gelenberg, A. J., Kupfer, D. J.,
Regier, D. A., Rosenbaum, J. F., Ray, O., & Schatzberg, A. F. (2006). Report by the ACNP Task Force on response and remission in
major depressive disorder. Neuropsychopharmacology, 31(9), 1841–1853.

2
https://www.childfirst.ucla.edu/resources/
3
Ibid.

© 2021 CAMH. To obtain permission to reproduce any part of this material, please contact 5
the Cundill Centre for Child and Youth Depression at cundill.centre@camh.ca. CAMH
is fully affiliated with the University of Toronto, and is a Pan American Health Organization.