Short version of the CES-D (Burnam screen) for depression in reference to the structured psychiatric interview

A new screen for depression was compared with clinician diagnoses based on the Structured Clinical Interview for DSM-IV (SCID) as the standard. Post-m enopausal women (n = 436) completed the Burnam screen, a short version of t he Center for Epidemiologic Studies Depression Scale (CES-D). The Burnam sc reen had a sensitivity of 74% and a specificity of 87% for current major de pression and dysthymia, but the positive predictive value was low (20%) and the overall error rate was 14%. For lifetime mood disorders, sensitivity w as very low for detecting affected subjects, even though specificity and po sitive predictive value were higher than for current conditions. Substituti ng a more sensitive cutpoint slightly improved the screen's ability to dete ct subjects with lifetime mood disorders. Even algorithms that used coeffic ients optimized for these data gave little improvement in the psychometric properties of the Burnam screen. These results re-emphasize the difficulty of using a one-stage screen to detect accurately a depressive diagnosis. (C ) 2001 Elsevier Science Ireland Ltd. All rights reserved.