title: Screening for depressive symptoms: validation of the center for epidemiologic studies depression scale (CES-D) in a multiethnic group of patients with diabetes in Singapore.
abstract: OBJECTIVE
  We determined the reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) against the DSM-IV-based diagnostic inventory, Schedule for Clinical Assessment in Neuropsychiatry (SCAN), in a multiethnic sample of adult subjects with diabetes attending a diabetes center in Singapore.
  
  
  METHODS
  A total of 522 subjects (74.7% Chinese, 11.1% Malay, and 14.2% Indian) completed culturally adapted versions of the CES-D; 291 subjects were administered the SCAN inventory.
  
  
  RESULTS
  The CES-D (cutoff score 16) showed high negative predictive values of more than 90% in all three ethnic groups. The prevalence of depressive symptoms (CES-D) and depression (SCAN) was significantly different between the Chinese and Indian subjects (CES-D 27.4 vs. 43.2%, P = 0.006); (SCAN 15.0 vs. 31.1%, P = 0.01).
  
  
  CONCLUSIONS
  The CES-D proved to be a reliable instrument for identifying patients with depressive symptoms in the multiethnic setting of this study.
authors.affiliation: Diabetes Centre, Alexandra Hospital, Singapore.
authors.forename: Dorit
authors.initials: D
authors.lastname: Stahl
authors.forename: Chee Fang
authors.initials: CF
authors.lastname: Sum
authors.forename: Shin Si
authors.initials: SS
authors.lastname: Lum
authors.forename: Pei Hsiang
authors.initials: PH
authors.lastname: Liow
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Swapna
authors.initials: S
authors.lastname: Verma
authors.forename: Hong Choon
authors.initials: HC
authors.lastname: Chua
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
mesh_terms: D003863:Depression / Q000453:epidemiology* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000523:psychology*; D005006:Ethnicity; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000379:methods; D010555:Personality Inventory; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012846:Singapore / Q000453:epidemiology