The criterion validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a sample of self-referred elders with depressive symptomatology.
BACKGROUND
The criterion validity of the Center for Epidemiological Studies Depression scale (CES-D) was assessed in a group of elderly Dutch community-residents who were self-referred to a prevention program for depression.


METHODS
Paper-and-pencil administration of the CES-D to 318 elders (55-85 years). Criterion validity was evaluated with the Mini International Neuropsychiatric Interview (MINI), a clinical diagnostic interview based on DSM-IV. Sensitivity and specificity for various cut-off scores of CES-D were compared with the DSM-IV major depressive disorder (MDD) and with clinically relevant depression (CRD), a composite diagnosis of MDD, subthreshold depression or dysthymia. Furthermore the characteristics of true versus false positives were analyzed.


RESULTS
For MDD, the optimal cut-off score was 25, (sensitivity 85%, specificity 64%, and positive predicted value of 63%). For CRD, the optimal cut-off was 22 (sensitivity 84%, specificity 60%, and positive predicted value 77%). True positives, MDD and CRD, reported significantly more anxiety symptomatology and more co-morbid anxiety disorders, false positives reported more previous depressive episodes.


CONCLUSIONS
The criterion validity of the CES-D for MDD and CRD was satisfactory in this semi-clinical sample of elders. Subjects scoring >/=25 constitute a target group for further diagnostic assessment in order to determine appropriate treatment.
Haringsma
R
R
Section of Clinical and Health Psychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands. haringsma@fsw.leidenuniv.nl
Engels
G I
GI
Beekman
A T F
AT
Spinhoven
Ph
P
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000517:prevention & control; D003951:Diagnostic Errors; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D012680:Sensitivity and Specificity