The Behavioral Medicine Report

The Center for Epidemiologic Studies publishes an excellent free psychological screening instrument for major depression called the The Center for Epidemiologic Studies-Depression Scale (CES-D). The CES-D serves a similar purpose as the ever popular Beck Depression Inventory-II, but with greater emphasis on the affective components of depression. The cost of this instrument ($0) makes it an attractive option to costly copyrighted depression scales. The CES-D is available in the public domain so check the end of this review to download the Stanford edition of the CES-D.

CES General Information
The CES-D is a 20-item self-report adult instrument designed to measure common symptoms of depression that have occurred over the past week, such as poor appetite, hopelessness, pessimism, and fatigue (Radloff, 1977). The CES-D takes approximately 5 minutes to complete. Questions are drawn from other depression inventories, such as the Zung Self-Rating Depression Scale (Zung SDS), the Beck Depression Inventory (BDI), and the Raskin Scale. All questions are answered on a scale of 0-3, with 0 indicating no symptom presence and with 3 representing symptoms “most or all of the time.” CES-D scores range from 0 to 60 with higher scores indicating more severe depressive symptoms. A score of 16 or higher identifies subjects with clinically meaningful depression (Radloff, 1977).

CES-D Psychometrics
Research demonstrates that the CES-D is valid and reliable instrument that can be used in research, and possibly clinical practice, to screen for common symptoms of major depression. The CES is particularly popular among researchers. Internal consistency using coefficient alpha is estimated to be .85 for the general population (healthy) and .90 in patient samples (Radloff, 1977). Most estimates of test-retest reliability from 2 weeks to 12 months fall in the moderate range (.45-.70); however, Radloff (1977) points out that moderate test-retest estimates are consistent with the CES-D’s design, which emphasizes current affective symptoms that are expected to fluctuate between test administrations. Researchers have also investigated the reliability and validity of the CES-D with African American, Asian American, French, Greek, Hispanic, Japanese, and Yugoslavian populations (Naughton and Wiklund 1993).

Summary
The CES-D is a cost effective, reliable, and valid screening instrument used to quickly assess the behavioral, cognitive, and affective symptoms of depression. The CES-D can be used without permission and is free of charge.

Download
Download the CES-D (Stanford Edition) CES-D Standford Version.

Reference:
Naughton MJ, & Wiklund I (1993). A critical review of dimension-specific measures of health-related quality of life in cross-cultural research. Qual Life Res 2:397–432.

Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.