Practice-based depression screening for psychiatry outpatients: Feasibility comparison of two-types of Center for Epidemiologic Studies Depression Scales


Takeshi Nishiyama, MD, MPH, PhD, Department of Information and Biological Sciences, Graduate School of Natural Sciences, Nagoya City University, 1 Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Email:


Aims:  The Center for Epidemiologic Studies Depression Scale (CES-D) has been validated to avoid misdiagnoses of major depression in routine psychiatric outpatient settings, but it was reported to be only marginally feasible in these specific settings. A briefer and simpler version, known as the 10-item CES-D, meant to attain adequate feasibility, has been validated in geriatric outpatient settings, but it has not yet been examined in psychiatry outpatient settings. The purpose of the present study was therefore to compare the feasibility, reliability, and validity of the two types of CES-D.

Methods:  A cross-sectional analysis was conducted of 86 consecutive outpatients in a psychiatric department in a general hospital.

Results:  The 10-item CES-D has a higher feasibility than the 20-item CES-D, and its internal consistency, reliability, and validity are almost identical to those of the 20-item CES-D.

Conclusions:  The 10-item CES-D is the better instrument to use because of the higher feasibility than the 20-item CES-D in psychiatric outpatient settings. The different answer format used in each questionnaire (a yes or no format in the former vs a multiple-choice format in the latter) may influence the feasibility, rather than the number of items.