The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.

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The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

Development and validation of a geriatric depression screening scale: A preliminary report

Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation

Un nouvel inventaire auto-administre destine a mesurer l'anxiete pathologique, le «Beck Anxiety Cheklist» (BAI) est decrit, evalue et compare au «Hamilton Anxiety Rating Scale» (test avec lequel des correlations moderees sont trouvees)

An inventory for measuring clinical anxiety: psychometric properties.

The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

The fact that there is a need for assessing depression, whether as an affect, a symptom, or a disorder is obvious by the numerous scales and inventories available and in use today. The need to assess depression simply and specifically as a psychiatric disorder has not been met by most scales available today. We became acutely aware of this situation in a research project where we needed to correlate both the presence and severity of a depressive disorder in patients with other parameters such as arousal response during sleep and changes with treatment of the depressive disorder. It was felt that the general depression scales used were insufficient for our purpose and that the more specific scales were also inadequate. These inadequacies related to factors such as the length of a scale or inventory being too long and too time consuming, especially for a patient

A self-rating depression scale.

A rating instrument for anxiety disorders

RECENT development and use of the Self-Rating Depression Scale (SDS) has Proven to be a valuable tool in the assessment of depressive disorders in a group of hospitalized inpatients. 1 There is a similar need in outpatient clinics to quantitate the amount of depressive symptomatology present or absent in the patients seen for treatment. Depressive symptoms may be present in any of the psychiatric disturbances seen in such a clinic, and a diagnosis of depressive disorder must still be made on a clinical basis. However, the use of such a scale is valuable in documenting and quantitating initial symptoms and complaints, and following changes in the patient's clinical course subsequent to treatment, using any of the modalities available. The purpose of a self-rating depression scale to be used in such an outpatient clinic setting would be similar to the ones stated previously with respect to its

Self-Rating Depression Scale in an Outpatient Clinic: Further Validation of the SDS

In a review of the past and current literature on the classification of depression as a psychiatric disorder, it is apparent that diagnosis and treatment go hand-in-hand. The original Kraepelinian concept of dividing depression by etiological factors into endogenous and exogenous has persisted so that modern thinking in psychiatry still espouses aspects of this in various guises. While the art of diagnosis and treatment may have declined, the science of diagnosis and treatment has made great strides with the advent of high-speed computers, sophisticated statistical analyses, and the birth of neuropsychopharmacology as a science. I will summarize my own work on the formulation of an operational definition of depression as a disorder, its application into a rating instrument, the various validity and reliability studies performed, as well as clinical application of the rating scale.

From art to science. The diagnosis and treatment of depression.

To test the hypothesis that depression is significantly underdiagnosed in general medical settings, the Zung Self-Rating Depression Scale was administered to 1,086 family medicine outpatients seen during a 12-month period before their initial medical examination. The effects of such screening on clinical recognition and treatment of depression were examined. Of the 1,086 patients, 143 (13.2%) were symptomatically depressed. These patients were randomized into two groups: 102 were identified as clinically depressed to their physician, and the remaining 41 were not (control group). Physicians diagnosed depression in 15% of the control group and in 68% of the identified group. At 4-week follow-up, 64% of the identified patients who were treated with maprotiline (16 of 25) showed improvement; only 28% of the identified patients who were electively not treated improved. Improvement occurred in only 18% of the control group. It appears that the diagnosis of depression is not ordinarily made in family medicine outpatient settings and that self-rating depression scales are useful diagnostic aids, whose regular use is indicated by the high prevalence of depression in general medical populations.

William W. K. Zung

Papers

A self-rating depression scale.

A rating instrument for anxiety disorders

Self-Rating Depression Scale in an Outpatient Clinic: Further Validation of the SDS

From art to science. The diagnosis and treatment of depression.

Recognition and treatment of depression in a family medicine practice