CESD-R Depression

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What is CESD-R

The Center for Epidemiologic Studies Depression Scale- Revised (CESD-R) is a 20 items screening test for depression and depressive disorder. The CESD-R measures symptoms of depression in nine different groups as defined by the American Psychiatric Association' Diagnostic and Statistical Manual (DSM-V) for a major depressive episode. These symptom groups are sadness (dysphoria), loss of interest (anhedonia), appetite, sleep, thinking/concentration, guilt (worthlessness), tired (fatigue), movement (agitation) and suicidal ideation.

CESD-R Printable PDF

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CESD-R Scoring and Interpretation

The response values for each question are:

Not at all or less than one day = 0
1-2 days = 1
3-4 days = 2
5-7 days = 3
Nearly every day for 2 weeks = 4

The Total CESD-R Score is calculated as a sum of responses to all 20 questions. In order to make the revised CESD-R have the same range as the original version i.e., the ‘CESD style score’), the values for the top two responses are given the same value:

Not at all or less than one day = 0
1-2 days = 1
3-4 days = 2
5-7 days = 3
Nearly every day for 2 weeks = 3

As in the original CESD the range of possible scores is between 0 (for those who say ‘not at all or less than one day to all 20 questions’ and 60 (for those who say ‘5-7 days’ or ‘nearly every day for 2 weeks’ for all 20 questions).

Special attention must be paid to the responses to item 14 and 15, as indicator of possible risk of self-harm.

For CESD-R scoring, the response values for each question are 0 (Not at all or less than one day), 1 (1-2 days), 2 (3-4 days), 3 (5-7 days) and 4 (Nearly every day for 2 weeks).

In order to make the revised CESD-R have the same range (0 to 60) as the original version i.e., the ‘CESD style score’; the response values for each question are 0 (Not at all or less than one day), 1 (1-2 days), 2 (3-4 days), 3 (5-7 days) and 3 (Nearly every day for 2 weeks).

PsyPack can automatically score the CESD-R assessment and prepare corresponding tables and graphs.

Sample Report of CESD-R

Domain

Depression

What does CESD-R measure

The purpose of the evaluation is to:

measure current level of depressive symptomatology, with emphasis on the affective component, depressed mood; and
screen for depression and depressive disorder.

Administration

Self-administered

Type of outcome tool

Clinical

Assessment modes

Questionnaire

Age and eligibility

18 years and above

Estimated time

5 to 10 minutes

Notes

Since the questionnaire relies on client self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the client understood the questionnaire, as well as other relevant information from the client.

The CESD-R is a screening tool and can therefore be used as a litmus test for treatment need but provides limited information relevant to prognosis.

Endorsement of item 14 or 15 (Suicidal Ideation) is an indicator of possible suicidal risk. A final decision about the actual risk of self-harm requires further assessment and clinical interview. Further assessment of suicide risk can be made by asking about the “4 P’s”: past suicide attempts, a plan, probability of completing suicide, and preventive factors.

The CESD-R scores are less useful in measuring response to treatment than scales based on objective intensity or impairment.

After making a provisional diagnosis with the CESD-R, there are additional clinical considerations that may affect decisions about management and treatment.

Have current symptoms been triggered by psychosocial stressor(s)?
What is the duration of the current disturbance and has the patient received any treatment for it? To what extent are the patient’s symptoms impairing his or her usual work and activities?
Is there a history of similar episodes, and were they treated?
Is there a family history of similar conditions?

Attribution and References

Radloff, L. S. (1977). The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Measurement, 1(3), 385–401. Eaton, W. W., Smith, C., Ybarra, M., Muntaner, C., & Tien, A. (2004). Center for Epidemiologic Studies Depression Scale: Review and Revision (CESD and CESD-R). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment: Instruments for adults (p. 363–377). Lawrence Erlbaum Associates Publishers.

Official website

Archived link

Eaton, W. W., Smith, C., Ybarra, M., Muntaner, C., & Tien, A. (2004). Center for Epidemiologic Studies Depression Scale: Review and Revision (CESD and CESD-R). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment: Instruments for adults (p. 363–377). Lawrence Erlbaum Associates Publishers.

Archived link

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.

Archived link