Shorter forms of the CES-D demonstrated lower reliability (alphas 0.53-0.83 vs 0.84) and tended to over-identify clinically relevant depressive symptoms compared to the 20-item scale.
Cross-Sectional (n=250)
Do short forms of the CES-D scale reliably and validly measure depressive symptoms in elderly women with chronic conditions compared to the 20-item scale?
Shorter forms of the CES-D scale are less reliable and tend to over-identify depression in elderly women with chronic conditions, requiring cautious interpretation.
OBJECTIVE: Depression is highly prevalent in elderly women with chronic conditions and measuring depressive symptoms is complicated by co-occurring chronic illnesses. The 20-item Center for Epidemiological Studies Depression (CES-D) Scale is commonly used with elders, but its length may result in missing data. Twelve short four to 16 item CES-D forms exist, but their psychometric properties have not been systematically evaluated. METHOD: This study of 250 elderly women compared reliability and validity estimates for the 20-item CES-D and its 12 short forms; all scales used four response alternatives. The study also investigated whether women with varying numbers of chronic conditions would be similarly classified as depressed based on standardized cut scores. RESULTS: Cronbach's alpha was 0.84 for the 20-item CES-D and alphas ranged from 0.53 to 0.83 for the short forms. Correlations between the 20-item CES-D and the short forms ranged from 0.77 to 0.96. Using the established 20-item CES-D cut score, 12% of the elderly women would be classified with clinically significant depressive symptoms. The shortest scales (four and five item) identified the greatest percentages of women as depressed while the 16-item scale identified the lowest. All 12 short forms showed a trend where more women were classified as depressed as their number of chronic conditions increased. CONCLUSION: The findings indicate a need for cautious interpretation of findings when shorter forms of the CES-D are used, particularly since shorter forms are less reliable and appear to over-identify women with chronic conditions as having clinically relevant depressive symptoms.
Zauszniewski et al. (Thu,) conducted a cross-sectional in Depressive symptoms in chronic conditions (n=250). Short forms of the CES-D (4 to 16 items) vs. 20-item CES-D was evaluated on Reliability (Cronbach's alpha) and depression classification rates. Shorter forms of the CES-D demonstrated lower reliability (alphas 0.53-0.83 vs 0.84) and tended to over-identify clinically relevant depressive symptoms compared to the 20-item scale.