CES-D Scale

Assesses the severity of depression symptoms based on a 20-item questionnaire.

You can read more about the CES-D scale and its interpretation, in the text below the calculator.


The CES-D scale evaluates depression severity based on symptoms extracted from a 20-item questionnaire.

Each of the questions rates the frequency by which depression symptoms are experienced, usually in a 2-week interval.

The questions focus on symptoms which have sensitivity and specificity in diagnosing a major depressive episode, as defined by the American Psychiatric Association Diagnostic and Statistical Manual (DSM-V).


The total CES-D score ranges between 0 and 60. There are three types of results:

■ Scores <15: no indication that a depressive disorder exists;

■ Scores between 15 and 21: mild to moderate depression;

■ Scores above 21: severe/ major depression.


1

I was bothered by things that usually don`t bother me

2

I did not feel like eating; my appetite was poor

3

I felt that I could not shake off the blues even with help from my family

4

I felt that I was just as good as other people

5

I had trouble keeping my mind on what I was doing

6

I felt depressed

7

I felt that everything I did was an effort

8

I felt hopeful about the future

9

I thought my life had been a failure

10

I felt fearful

11

My sleep was restless

12

I was happy

13

I talked less than usual

14

I felt lonely

15

People were unfriendly

16

I enjoyed life

17

I had crying spells

18

I felt sad

19

I felt that people disliked me

20

I could not "get going"

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CES-D explained

As a depression screening tool, the CES-D consists of 20 questions referring to the most common depression symptoms.

The instruction for the subject before administering the questionnaire is to think of what they have experienced in the last two weeks and as they go through the questions, to rate the frequency with the help of the answer choices.

The items refer to major depressive symptoms as defined by the American Psychiatric Association Diagnostic and Statistical Manual (DSM-V).

Questions 4, 8, 12 and 16 are different from the rest as they use an opposite wording and refer to feelings of happiness and confidence rather than restlessness or failure:

1. I was bothered by things that usually don’t bother me.
2. I did not feel like eating; my appetite was poor.
3. I felt that I could not shake off the blues even with help from my family.
4. I felt that I was just as good as other people.
5. I had trouble keeping my mind on what I was doing.
6. I felt depressed.
7. I felt that everything I did was an effort.
8. I felt hopeful about the future.
9. I thought my life had been a failure.
10. I felt fearful.
11. My sleep was restless.
12. I was happy.
13. I talked less than usual.
14. I felt lonely.
15. People were unfriendly.
16. I enjoyed life.
17. I had crying spells.
18. I felt sad.
19. I felt that people disliked me.
20. I could not "get going".

CES-D allows the subject to assess their mental status and offers information as to whether they require professional help or not.

Depressive disorder like other mental health conditions interferes with patient perception and leads to alteration of quality of life and serious consequences if left untreated.

The usage of a scale that draws alarm on depressed mood and feelings of guilt, worthlessness, helplessness or hopelessness can be the first point of diagnosis so that patients receive adequate treatment and a chance to rehabilitation.

 

Score interpretation

For each of the 20 questions, the answer is rated on a scale from 0 to 3, therefore, the total score ranges between 0 and 60.

The available answer choices, their meaning and points awarded are explained in the table below:

Answer choice Meaning Points
Rarely or none of the time Under 1 day in the 2 week interval 0
Some or a little of the time 1-2 days in the assessed interval 1
Occasionally or a moderate amount of the time 3-4 days in the 2 week interval 2
Most or all of the time 5-7 days in the assessed interval 3

Please pay attention that in questions 4, 8, 12 and 16 the points awarded to the scale are reversed, because the wording of the question relates to opposite symptoms, such as happiness, hopefulness and confidence.

There are three score intervals:

■ Scores <15 carry no indication that a depressive disorder exists, however, further monitoring is recommended.

■ Scores between 15 and 21 are indicative of mild to moderate depression.

■ Scores above 21 indicate severe/ major depression and the initiation of therapeutic measures is compulsory.

 

About the study

The Center for Epidemiological Studies Depression Scale was created in 1977 by Radloff to serve as screening method in the psychiatric epidemiology of depression.

The CES-D is now used widely, on patient populations from children to the elderly and a further revised version was created in 2004 by Eaton.

The study used items that have been previously validated in longer scales. The resultant scale was tested in household interview surveys and in psychiatric settings and was found to have very high internal consistency and adequate test- retest repeatability.

Reliability, validity, and factor structure were found to be similar across general population samples, therefore the score can be successfully used in epidemiologic studies.

 

Original source

Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977; 1:385-401.

Other references

1. Radloff LS. The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. J Youth Adolesc. 1991; 20(2):149-66.

2. Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients. Evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). Journal of Psychosomatic Research. 1999; 46, 437-443.

3. Eaton WW, Muntaner C, Smith C, Tien A, Ybarra M. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). In: Maruish ME, ed. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum. 2004; 363-377.


App Version: 1.0.1

Coded By: MDApp

Specialty: Psychiatry

System: Nervous

Objective: Evaluation

Type: Scale

No. Of Items: 20

Year Of Study: 1977

Abbreviation: CES-D

Article By: Denise Nedea

Published On: May 25, 2017 · 08:19 AM

Last Checked: May 25, 2017

Next Review: May 25, 2018