Depression in rural communities: Validating the CES-D scale

This study of 200 adults receiving outpatient services in rural Middle Tennessee was conducted to provide data on the validity of the CES-D as a measure of depressive symptomatology. Specifically, the study sought to determine the CES-D's ability to discriminate between outpatients and a sample of community residents, between patient groups reflecting different diagnostic classifications and levels of problem severity, and based upon such comparisons, to select cutting points on the CES-D which would indicate levels of depressive symptomatology which denote a need for services. The data indicated that the CES-D distinguished (1) between patients and nonpatients, (2) among various patient groups, and (3) among depressed patients with varying levels of problem severity. Further, the study cites the utility of new cutting points of 17 and 23 to provide an estimate of “possible” and “probable” caseness within the community. The study provides support for the utility of the CES-D in determining levels of depressive symptomatology in the population.