• A screening measure (NOT a diagnostic tool) developed to identify current depressive symptomatology related to major or clinical depression in adults and adolescents (Radloff 1977).
• Items include depressed mood, feelings of guilt, worthlessness and helplessness, psychomotor retardation, loss of appetite and sleep difficulties. 

Number of items: There are 10 and 20 item versions of the scale.

Procedure/Administration: Self report using pen/paper or interview. Responses are based on the frequency of occurrence during the past week.  Uses a 4-point ordinal scale: Rarely or none of the time (less than 1 day); Some or a little of the time (1-2 days); Occasionally or a moderate amount of the time (3-4 days); Most or all of the time (5-7 days).

How scored: A summary score is calculated. The range of scores on the CES-D-20 is 0-60 (0-30 for the CES-D-10)

Interpretability: A CES-D -20 cutoff score of 16 is indicative of “significant” or “mild” depressive symptomatology, and a cut score of 11 for the shorter version is recommended. It is equivalent to experiencing six symptoms for most of the previous week or a majority of symptoms on one or two days. Higher scores indicating greater symptoms.

Acceptability: N/a

Languages: Translations are available.

Usability: N/a

Time to administer: The measure is easy to complete (grade 4 reading level) and takes 5 – 10 minutes.

Time to score: The measure is easy to score and burden is likely minimal.

Training required: N/a

Availability: N/a

Equipment required: N/a

Summary:

• The CES-D- 20 was created for the general population but has been used extensively in SCI (cited in approximately 50 SCI research articles). Shorter versions such as the 10, 8 and 4 item are available but only the CES-D 10 has been assessed in the SCI population.

Psychometric Summary:

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

N/a= No information.

 *Data adequate for Thai version of CES-D, not for English version.

References

• Kuptniratsaikul V, Chulakadabba S, Ratanavijitrasil S. An instrument for Assessment of Depression among Spinal Cord Injury Patients: Comparison between the CES-D and the TDI. J Med Assoc Thai 2002; 85:978-982
• Radloff LS. CES-D scale: A self report depression scale for research in the general populations. Applied Psychological Measurement 1977;1:385-401.
• Radloff LS. The Use of the Center for Epidemiological Studies of Depression Scale in Adolescents and Young Adults. J Youth Adoles 1991;20:149-166.