The Center for Epidemiologic Studies Depression Scale (CES-D)

The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of depression.

The CES-D was developed in the 1970s by Lenore Radloff while she was a researcher at the National Institute of Mental Health. Almost 85% of those found to have depression after an in-depth structured interview with a psychiatrist will have a high score on the CESD. However, about 20% of those who score high on the CESD will have rapid resolution of their symptoms and not meet full criteria for major or clinical depression.

For the 20 items below, circle the number next to each item that best reflects how frequently the indicated event was experienced in the past 7 days.

Rarely or none of the time (less than 1 day)
Some or a little of the time (1-2 days)
Occasionally or a moderate amount of time (3-4 days)
Most or all of the time (5-7 days)
DURING THE PAST WEEK:
1. I was bothered by things that usually don’t bother me.
0
1
2
3
2. I did not feel like eating; my appetite was poor.
0
1
2
3
3. I felt that I could not shake off the blues even with help from my family or friends.
0
1
2
3
4. I felt that I was just as good as other people.
3
2
1
0
5. I had trouble keeping my mind on what I was doing.
0
1
2
3
6. I felt depressed.
0
1
2
3
7. I felt that everything I did was an effort.
0
1
2
3
8. I felt hopeful about the future.
3
2
1
0
9. I thought my life had been a failure.
0
1
2
3
10. I felt fearful.
0
1
2
3
11. My sleep was restless.
0
1
2
3
12. I was happy.
3
2
1
0
13. I talked less than usual.
0
1
2
3
14. I felt lonely.
0
1
2
3
15. People were unfriendly.
0
1
2
3
16. I enjoyed life.
3
2
1
0
17. I had crying spells.
0
1
2
3
18. I felt sad.
0
1
2
3
19. I felt that people disliked me.
0
1
2
3
20. I could not get "going."
0
1
2
3

Scoring: Since items 4, 8, 12, and 16 reflect positive experiences rather than negative ones, the scale should be reversed on these items so that 0 = 3, 1 = 2, 2 = 1, and 3 = 0. To determine the "depression score," add together the numbers for each answer. The score will be somewhere in the range of 0 to 60. A score of 16 or greater indicates that some depression may have been experienced in the past week.

Scoring and Assessment

Less than 16 Depression is not indicated
Consult a social worker to address any concerns you may have. People with scores in this range usually do not have clinical depression. However, emotional distress can be common in people with cancer. You are encouraged to get assistance from friends, family, clergy, social worker or your primary health care team.

16 - 20 Mild depression indicated
Seek assistance from mental health professional and/or a physician. People with scores in this range usually have a mild clinical depression that should be addressed. Getting help is not a sign of weakness; depression is a medical illness that can commonly affect people with cancer.

21-25 Moderate depression indicated
Seek assistance from mental health professional and/or a physician. People with scores in this range usually have a moderate clinical depression that should be addressed. Getting help is not a sign of weakness; depression is a medical illness that can commonly affect people with cancer.

26 or higher Severe depression indicated
It is important that you get assistance as soon as possible from your physician or mental health professional. People with scores in this range usually have a severe clinical depression. Getting help is not a sign of weakness; depression is a medical illness that can commonly affect people with cancer.




Sources and Additional Information:

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