Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) among people in treatment for substance use disorders

Background: Comorbidities found high rates of psychiatric comorbidity among people with substance use disorders. Mood and anxiety disorders are the most frequent. Objective: To evaluate the psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) for a clinical sample of people with a drug addiction diagnosis. Method: 513 outpatients from two public health services for substance abuse treatment participated in this study. To assess the construct validity in our sample, we used a confirmatory factorial analysis (CFA), comparing two previous versions of CES-D that had evidence of validity for other Brazilian populations. Divergent and convergent validity was evaluated using Pearson's correlation test. Reliability coefficients were calculated by Cronbach's alpha (α) and average split-half test. Results: A four dimensions structure fitted well to our data with a better performance. Convergent validity was supported by a moderate positive correlation between CES-D factors and self-stigma. Divergent validity was supported by a negative moderated correlation with hope and self-esteem. Conclusions: The psychometric properties of our proposed model supports the use of CES-D to evaluate depression symptoms among people in treatment for substance use disorders.