Second, at phases 7 and 9, depressive symptoms were also assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) (note that CES-D was not included in earlier screening phases of our study) (29). The 20 items of the CES-D measure symptoms associated with depression; participants are asked to score the frequency of occurrence of specific symptoms during the previous week on a four point scale (0 = less than one day, 1 = 1–2 days, 2 = 3–4 days, and 3 = 5–7 days). These items are summed to yield a total score between 0 and 60, with participants scoring ≥16 defined as having CES-D depressive symptoms (30). In a validation study of 274 Whitehall II participants, sensitivity and specificity were 89% and 86%, respectively, for CES-D depressive symptoms using a structured psychiatric interview as the criterion.
CES-D
20 items
items
scale
four point
point
four point scale
0
less than one day
day
four point scale
1
1–2 days
days
four point scale
2
3–4 days
days
four point scale
3
5–7 days
days
total score
between 0 and 60
defined as having CES-D depressive symptoms
scoring
≥16
validation study
274 Whitehall II participants
Whitehall II participants
structured psychiatric interview
sensitivity
89%
%
structured psychiatric interview
specificity
86%
%