The Center for Epidemiologic Studies Depression Scale (CESD-R) is a 20 item self-report questionnaire used to measure symptoms of depression, and is particularly useful for tracking symptoms over time. It taps into nine different symptom groups of Major Depressive Disorder as defined by the American Psychiatric Association Diagnostic and Statistical Manual, fifth edition (DSM-V). These symptom groups are:
- Sadness (dysphoria)
- Loss of Interest (anhedonia)
- Thinking / concentration
- Guilt (worthlessness)
- Tired (fatigue)
- Movement (agitation)
- Suicidal ideation
When used in conjunction with DSM-V criteria and clinical judgment this scale is useful for diagnosis of Major Depressive Disorder.
Validity and Reliability #
Van Dam and Earleywine (2011) validated the CESD-R on a large community same (N = 7389, mean age = 30.2, SD = 12.1). Factor analysis showed one factor and that the scale had good internal consistency and psychometric properties. In their community sample total score range of 0 to 77 (M = 10.3, S.D. = 11.7). The distribution of CESD-R scores had a large positive skew, meaning that percentiles derived from this data should be treated with caution. They also evaluated the scale with an undergraduate student sample (mean age 19.5 (SD=1.8), showing a higher mean of 16.4 (SD = 13.5).
Scoring and Interpretation #
Scores are presented as total raw scores as well and two percentiles, one based on a community sample of adults and the other based on a student sample (mean age = 19.5). High scores indicate more symptoms of depression.
Further interpretation of individual responses can be done in light of the symptoms clusters of Major Depressive Disorder.
1 – Sadness (Dysphoria): Questions 2, 4, 6
2 – Loss of Interest (Anhedonia): Questions 8, 10
3 – Appetite: Questions 1, 18
4 – Sleep: Questions 5, 11, 19
5 – Thinking / concentration: Questions 3, 20
6 – Guilt (Worthlessness): Questions 9, 17
7 – Tired (fatigue): Questions 7, 16
8 – Movement (Agitation): Questions 12, 13
9 – Suicidal ideation: Questions 14, 15
According to the DSM-5 criteria, diagnosis of Major Depressive disorder can be made if five (or more) of the above symptoms clusters are endorsed and at least one of the symptom is either (1) depressed mood or (2) loss of interest in pleasure.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385-401.
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.
Van Dam, N. T., & Earleywine, M. (2011). Validation of the Center for Epidemiologic Studies Depression Scale—Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128-132.