THE CENTER FOR EPIDEMIOLOGIC STUDIES DEPRESSION (CES-D) SCALE - ASSESSMENT OF DEPRESSION IN THE MEDICALLY ILL ELDERLY

This study examines the use of the Center for Epidemiological Studies- Depression Scale (CES-D) in a sample of elderly, medically ill inpatie nts. Seventy-six individuals completed the CES-D and a psychiatric int erview, from which DSM-III-R diagnoses of depression were obtained. An alyses of sensitivity and specificity indicated that use of an alterna tive scoring method which more closely approximates current diagnostic criteria for depression may improve the predictive power of the test. Employment of stringent cut-scores was not supported, as sensitivity was compromised. Item analyses demonstrated that seven of the CES-D it ems failed to discriminate major, minor and nondepressed patients, and that several of these items tapped somatic symptoms. These findings s uggest that the validity of the CES-D may be compromised when used wit h elderly medical patients, and modifications for its use are recommen ded. (C) 1997 by John Wiley gi Sons, Ltd.