Psychometric properties of the Center for Epidemiologic Studies-Depression scale in elderly primary care patients

Authors: Cristina Imaginário1; Anoberta Santos1; Isabel Barroso1; João Pereira2; José Dias1; Conceição Rainho1.
1 – Escola Superior de Enfermagem de Vila Real
2 – Centro de Saúde de Chaves nº1


1. Introduction

Depressive disorders are most common seen in primary care practice. The Center for Epidemiologic Studies-Depression (CES-D) scale is one of the measures commonly recommended for detecting depression in this context. Little data have been documented in the scientific literature in assessing symptoms of depression, in the elderly Portuguese living in nursing homes and in the community.

2. Objective
The aim of this study is to verify the validity and reliability of the (CES-D) scale,
and assessing depressive symptoms and the difference of means of scores in elderly Portuguese people living in nursing home and in community.

3. Methods:

The scale CES-D is 20-item, an instrument that measures the current level of depression symptoms.
This study was developed in December 2005. Interviews were conducted by trained interviewers in the houses of the participants and in nursing homes.
Reliability was assessed by Cronbach's alpha; the factorial structure of the (CES-D) scale was examined. When comparing means in quantitative variables, we used Student test for independent samples.

4. Results:

There were 83 participants with an average age of 76,7 years ± 8,0,31,3% men and 68,7% women.
As previously reported in the literature, we found five factors that measure emotional depression, positive emotional factors, somatic complaints, retarded activity and interpersonal relationships. The percentage of total variance explained by the five factors was 65% in the sample. Chronbach's alpha for the total scale was equal to 0.89, indicative of high reliability.
The averages of depression level were significantly higher in the elderly that live in nursing homes.

5. Conclusions
We conclude that the CES-D can be used to screen depression in epidemiological studies of this psychiatric disorder among the Portuguese elderly.
Depression is an important public heath concern and early identification is crucial for instituting early intervention programs for the elderly population.