Name: Center for Epidemiologic Studies Depression Scale (CES-D).
Source: National Institute of Mental Health; LS Radloff.* Click here for a sample of the CES-D.
Description: The CES-D is a 20-item instrument developed by NIMH to detect major or clinical depression in adolescents and adults in community samples. The questions are easy to answer and cover most of the areas included in the diagnostic criteria for depression. It has been used in urban and rural populations, and to assess depression in cross-cultural populations.* A limitation of the CES-D is that there is little published psychometric data on the use of this tool in postpartum women. In addition, according to Boyd et al, the sensitivity and specificity values thus far indicate that the CES-D could potentially miss as many as 40% of depressed postpartum women.
Scores: Scores range from 0-60, with depressive symptomatology indicated at a cutoff of 16 or above.
Accuracy: According to a review of validated screening instruments by Boyd et al, the CES-D had the following sensitivity (testing positive), specificity (testing negative), and positive predictive values (actual disease based on 13% prevalence rates):
Positive predictive value: 53%
Time frame: The CES-D takes approximately 10 minutes to administer during a client interview or via self-report and is used effectively in a variety of mental health areas, including primary care, psychiatric and related clinical and forensic settings.*
Cost of the tool: Free.*
*Information provided courtesy of the National Mental Health Association.
Relevant Literature About the CES-D:
Beeghly M, Weinberg MK, Olson KL, Kernan H, Riley J, Tronick EZ. Stability and change in level of maternal depressive symptomatology during the first postpartum year. J Affect Disord. 2002 Sep;71(1-3):169-180.
Boyd RC, Le HN, Somberg R. Review of screening instruments for postpartum depression. Arch Womens Ment Health. 2005;8:141-153.
Chaudron LH, Klein MH, Remington P, Palta M, Allen C, Essex MJ. Predictors, prodromes and incidence of postpartum depression. J Psychosom Obstet Gynaecol. 2001 Jun;22(2):103-112.
Locke R, Baumgart S, Locke K, Goodstein M, Thies C, Greenspan J. Effect of maternal depression on premature infant health during initial hospitalization. J Am Osteopath Assoc. 1997 Mar;97(3):145-149.
Mosack V, Shore ER. Screening for depression among pregnant and postpartum women. J Community Health Nurs. 2006 Spring;23(1):37-47.
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