Somatic Complaints and the CES‐D

Objective To evaluate the Center for Epidemiology Surveys‐Depression (CES‐D) scale for inordinate false positives, due to measurement of non‐depression‐related somatic complaints. Design Cross‐sectional correlation of analysis of random multi‐cluster samples. Setting Thirteen counties considered representative of the community‐dwelling elderly population of Alabama. Participants One‐thousand‐sixty persons aged 55 and older. Intervention None. Main Outcome Measures Study evaluated the relationship of somatic symptomatology, as measured by the Multi‐Level Assessment Instrument's Physical Health Domain Index (PHDI) composite score and its three component indices, with the CES‐D and its four component scales, particularly the Somatic scale. Results The CES‐D total score and the Somatic scale were not related to: age increases in the sample; PHDI composite score or the three index scores; or to subgroups of high and low PHDI composite scores. Among those screened as depressed, the PHDI and the three indices were not related to the CES‐D total score or three of the four subscales. The CES‐D Somatic scale was positively related to those depressed persons with the highest number of total PHDI somatic complaints. However, among the depressed group there were more persons scoring greater than 1.5 standard deviations above the mean on the CES‐D Depressive Affect scale ( n = 81) than on the Somatic scale ( n = 65). Conclusions The CES‐D and its Somatic scale were relatively unbiased by the respondent's somatic complaints. The CES‐D can continue to be considered valid under these circumstances.