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Center for Epidemiological Studies Depression - Revised

Center for Epidemiological Studies Depression - Revised

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

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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.



Type of outcome tool


Assessment modes


Age and eligibility

18 years and above

Estimated time

5 to 10 minutes


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.