The criterion validity of the Center for Epidemiological Studies Depression Scale (CES‐D) in a sample of self‐referred elders with depressive symptomatology

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Abstract
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. Copyright © 2004 John Wiley & Sons, Ltd.