title: Using the Center for Epidemiologic Studies Depression Scale to screen for depression in systemic lupus erythematosus.
abstract: OBJECTIVE
  Identifying persons with systemic lupus erythematosus (SLE) at risk for depression would facilitate the identification and treatment of an important comorbidity conferring additional risk for poor outcomes. The purpose of this study was to determine the utility of a brief screening measure, the Center for Epidemiologic Studies Depression Scale (CES-D), in detecting mood disorders in persons with SLE.
  
  
  METHODS
  This cross-sectional study examined 150 persons with SLE. Screening cut points were empirically derived using threshold selection methods, and receiver operating characteristic curves were estimated. The empirically derived cut points of the CES-D were used as the screening measures and were compared to other commonly used CES-D cut points in addition to other commonly used methods to screen for depression. Diagnoses of major depressive disorder or other mood disorders were determined using a "gold standard" structured clinical interview.
  
  
  RESULTS
  Of the 150 persons with SLE, 26% of subjects met criteria for any mood disorder and 17% met criteria for major depressive disorder. Optimal threshold estimations suggested a CES-D cut score of 24 and above, which yielded adequate sensitivity and specificity in detecting major depressive disorder (88% and 93%, respectively) and correctly classified 92% of participants. To detect the presence of any mood disorder, a cut score of 20 and above was suggested, yielding sensitivity and specificity of 87% and correctly classifying 87%.
  
  
  CONCLUSIONS
  These results suggest the CES-D may be a useful screening measure to identify patients at risk for depression.
authors.affiliation: University of California, San Francisco, CA, USA. Laura.julian@ucsf.edu
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Julian
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.forename: Chris
authors.initials: C
authors.lastname: Tonner
authors.forename: Jinoos
authors.initials: J
authors.lastname: Yazdany
authors.forename: Laura
authors.initials: L
authors.lastname: Trupin
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Criswell
authors.forename: Ed
authors.initials: E
authors.lastname: Yelin
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012307:Risk Factors; D012720:Severity of Illness Index