Shortening the CES-D to improve its ability to detect cases of depression

Psychometric analyses evaluated how primary care patients with and without major depressive disorder endorsed individual response options on the Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977). The analyses were then used to identify a subset of items that when appropriately weighted improved the efficiency with which depressed individuals were identified. Efficiency of the revised measure was evaluated relative to standard cutpoints used with the full scale. Results showed that some improvement in most indices of efficiency could be achieved with half as many items and a simplified scoring scheme, but great improvement in one measure was usually achieved only at the expense of other measures of efficiency. The efficiency of the CES-D can be improved with appropriate analytic techniques, but its limitations as a self-report screening measure persist.