Self-report Depression Scales

The major limitation of Boyd et al's study lies with the questionnaire employed, the Center for Epidemiologic Studies—Depression Scale (CES-D), and generalization to other selfreport scales may be inappropriate.

Abstract

To the Editor.— Boyd et al recently attempted to delineate the reasons for the discrepancies in case identification between self-report depression scales and diagnosis based on personal interview (Archives1982;39:1195-1200). It seems that the major limitation of their study lies with the questionnaire employed, the Center for Epidemiologic Studies—Depression Scale (CES-D). Generalization to other selfreport scales may be inappropriate. Careful examination of the content of the CES-D reveals two major problems that may account for their findings. First, many items on the scale are not criterion symptoms of major depressive disorder (MDD). Some, in fact, can be better viewed as symptoms of other syndromes (eg, "I felt fearful"), and this may partly explain the 17% of subjects who had CES-D scores above the cutoff, but other Research Diagnostic Criteria (RDC) diagnoses (such as phobic disorder). Other CES-D items are criterion symptoms of other depressive disorders such as minor depression (eg,