Center for Epidemiological Studies-Depression

Construct: Depressive symptoms

DepressionDescription of Measure: The Center for Epidemiological Studies-Depression (CES-D), originally published by Radloff in 1977, is a 20-item measure that asks caregivers to rate how often over the past week they experienced symptoms associated with depression, such as restless sleep, poor appetite, and feeling lonely. Response options range from 0 to 3 for each item (0 = Rarely or None of the Time, 1 = Some or Little of the Time, 2 = Moderately or Much of the time, 3 = Most or Almost All the Time). Scores range from 0 to 60, with high scores indicating greater depressive symptoms.

The CES-D also provides cutoff scores (e.g., 16 or greater) that aid in identifying individuals at risk for clinical depression, with good sensitivity and specificity and high internal consistency (Lewinsohn, Seeley, Roberts, & Allen, 1997). The CES-D has been used successfully across wide age ranges (Lewinsohn et al., 1997), is sensitive to differences between caregivers and non-caregivers (Pinquart & Sorensen, 2003), and is sensitive to changes in caregiver depressive symptoms after intervention (Pinquart & Sorensen, 2006). Although the CES-D has somewhat different factor structures across racial and ethnic groups, it can be used appropriately with diverse caregivers (Roth et al., 2008).


Lewinsohn, P.M., Seeley, J.R., Roberts, R.E., & Allen, N.B. (1997). Center for Epidemiological Studies-Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12, 277- 287.

Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurements, 1, 385-401.

Pinquart, M., & Sorensen, S. (2003). Differences between caregivers and non-caregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18, 250–267.

Pinquart, M., & Sörensen, S. (2006). Helping caregivers of persons with dementia: Which interventions work and how large are their effects? International Psychogeriatrics, 18, 577-595.

Roth, D.L., Ackerman, M. L., Okonkwo, O. C., & Burgio, L. D. (2008). The four-factor model of depressive symptoms in dementia caregivers: A structural equation model of ethnic differences. Psychology and Aging, 23, 567–576.