Center for Epidemiologic Studies Depression Scale

Introduction

There are multiple questions, tests, and tools that help clinicians identify certain symptoms correlating with the conditions their clients may deal with. Depending on the characteristics of the tool, the results can facilitate effective diagnosing and the subsequent treatment plan that will alleviate symptoms and compromise the adverse effects. In this paper, the Center for Epidemiologic Studies Depression Scale (CES-D) will be examined in regards to its purpose, the way to administer it, and its importance.

Overview

The name Center for Epidemiologic Studies Depression Scale (CES-D) highlights the institution where the scale was developed and the symptoms it may establish concerning the patient. Radloff published the ranking in 1977, and the initial version included 20 items (Radloff, 1977). It is a self-report questionnaire, which means that the patient rates the items within the scale based on the feelings, emotions, and thoughts throughout the past week. Thus, the assessment allows the individual to examine internal feelings instead of the method that clinician-rated evaluation measures have in which the therapist evaluates the patient. As a result, individuals are able to go in-depth in regards to specific feelings that may correlate with symptoms of depression. Hence, the participants are evaluated by the person administering the test, yet the responses are given directly by the patients who are filling in the questionnaire.

Purpose and Measures

The scale is not intended to be a diagnosis of depression. However, researchers mention that the scale is often used in challenging settings and shows high-quality results, as exemplified in its practical appliance in patients dealing with oncological conditions (Saracino et al., 2020). The assessment, however, has to do with the evaluation of certain symptoms of depression, which can later be the basis for further diagnostic measures. Thus, the purpose is to establish the indication of depression or depression tendencies in patients. Using this particular evaluation tool is helpful to patients since it looks at the different manifestations of the condition and perceptions, including the depressed or positive affect. Moreover, the evaluation allows for an assessment of somatic implications and interpersonal difficulties.

The evaluation tool is used to measure symptoms of depression. There are multiple versions of the scale, including CES-D 10 (1O items) and the regular CES-D (20 items) (Kilburn et al., 2018). CES-D 10 only includes the following questions: regarding bothersome events, compulsive thoughts, feelings of depression, effort, hopefulness, fear, sleep, happiness, loveliness, and drive. The 20-item scale additionally examines patterns of crying, feeling of failure, assessment of the external environment, appetite, engagement, sadness, and isolation. The patient is able to rate each question from 0 to 3 on a weekly basis, 0 meaning rarely while 3 – most days. Clinicians evaluate the patients based on their responses and the final measure, which can range from 0 to 60, with a number higher than 16 considered significant. Improvements occur when the pre-test and post-test show the lowering of the clinically significant measure assessed prior. Thus, in case the initial evaluation shows the scale results as 22 while the same scale administered after the intervention indicates the number to be 8, an improvement can be observed.

Frequency of Administration

Each clinician chooses the frequency of applying the evaluation measure based on the specific characteristics of the treatment plans, the patient, and every individual case. However, the scale itself is intended to be used to examine the patient’s concerns and emotions over the previous week (Jiang et al., 2019). I would administer the scale on a weekly basis for two reasons. On the one hand, it will allow for an examination of the disease progression or regression. On the other hand, the weekly method can facilitate the determination of whether the overall treatment plan is effective or requires additional intervention. Thus, patients can be evaluated in regard to their depression-related symptoms, and alterations can be made to maximize positive results.

Treatment

As mentioned prior, the scale is effective in illustrating symptoms of depression. While this is not the only implication during the diagnosing process, it can facilitate the construction of a treatment plan as well as its evaluation. In case the scale shows a measure of 16 or higher, I would use the results as evidence of the need for urgent treatment. Furthermore, if the subsequent evaluation shows an improvement or progression of the disease, I can use the measures to assess whether changes are needed in the treatment plan. Moreover, the aspects evaluated through the scale can be addressed individually (Blodgett et al., 2021). For example, during a week in which the measures of interpersonal challenges are higher, I can focus the therapeutical implications on this particular subject. Moreover, the information received as a result of the administration of the evaluation measure can contribute to a better understanding of the timing of treatment termination. Thus, if the clinically-shown measure of 16 regresses to a lower number, the treatment can be terminated.

Conclusion

Evidence shows that the Center for Epidemiologic Studies Depression Scale is an effective evaluation tool for asses symptoms related to depression. There are multiple ways in which the tool can be administered, starting from the number of items included and the demographics to which the assessment applies. The scale helps during the diagnosis process, yet is not the only requirement for establishing the presence of depression. Nonetheless, the scale contributes to the formation of a comprehensive opinion on the state of the patient and the progression of the treatment.

References

Blodgett, J. M., Lachance, C. C., Stubbs, B., Co, M., Wu, Y. T., Prina, M., Tsang, V. W., & Cosco, T. D. (2021). A systematic review of the latent structure of the Center for Epidemiologic Studies Depression Scale (CES-D) amongst adolescents. BMC Psychiatry, 21(1).

Jiang, L., Wang, Y., Zhang, Y., Li, R., Wu, H., Li, C., Wu, Y., & Tao, Q. (2019). The reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese University Students. Frontiers in Psychiatry, 10.

Kilburn, K., Prencipe, L., Hjelm, L., Peterman, A., Handa, S., & Palermo, T. (2018). Examination of performance of the Center for Epidemiologic Studies Depression Scale Short Form 10 among African youth in poor, rural households. BMC Psychiatry, 18(1).

Radloff, L. S. (1977). The CES-D scale. Applied Psychological Measurement, 1(3), 385–401.

Saracino, R. M., Cham, H., Rosenfeld, B., & Nelson, C. J. (2020). Confirmatory factor analysis of the Center for Epidemiologic Studies Depression Scale in oncology with examination of invariance between younger and older patients. European Journal of Psychological Assessment, 36(2), 229–236.