+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Validating a Shortened Depression Scale (10 Item CES-D) among HIV-Positive People in British Columbia, Canada


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          To establish the reliability and validity of a shortened (10-item) depression scale used among HIV-positive patients enrolled in the Drug Treatment Program in British Columbia, Canada.


          The 10-item CES-D (Center for Epidemiologic Studies Depression Scale) was examined among 563 participants who initiated antiretroviral therapy (ART) between August 1, 1996 and June 30, 2002. Internal consistency of the scale was measured by Cronbach’s alpha. Using the original CES-D 20 as primary criteria, comparisons were made using the Kappa statistic. Predictive accuracy of CES-D 10 was assessed by calculating sensitivity, specificity, positive predictive values and negative predictive values. Factor analysis was also performed to determine if the CES-D 10 contained the same factors of positive and negative affect found in the original development of the CES-D.


          The correlation between the original and the shortened scale is very high (Spearman correlation coefficient  = 0.97 (P<0.001). Internal consistency reliability coefficients of the CES-D 10 were satisfactory (Cronbach α = 0.88). The CES-D 10 showed comparable accuracy to the original CES-D 20 in classifying participants with depressive symptoms (Kappa = 0.82, P<0.001). Sensitivity of CES-D 10 was 91%; specificity was 92%; and positive predictive value was 92%. Factor analysis demonstrates that CES-D 10 contains the same underlying factors of positive and negative affect found in the original development of the CES-D 20.


          The 10-item CES-D is a comparable tool to measure depressive symptoms among HIV-positive research participants.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Coefficient alpha and the internal structure of tests

          Psychometrika, 16(3), 297-334
            • Record: found
            • Abstract: found
            • Article: not found

            Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).

            We derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large Health Maintenance Organization. The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D (kappa = .97, P or = 16 for the full-length questionnaire and > or = 10 for the 10-item version. We discuss other potential cutoff values. The CESD-10 showed an expected positive correlation with poorer health status scores (r = .37) and a strong negative correlation with positive affect (r = -.63). Retest correlations for the CESD-10 were comparable to those in other studies (r = .71). We administered the CESD-10 again after 12 months, and scores were stable with strong correlation of r = .59.
              • Record: found
              • Abstract: found
              • Article: not found

              Meta-analysis of the relationship between HIV infection and risk for depressive disorders.

              Each of 10 published studies investigating the relationship between HIV infection and risk for depressive disorders concluded that HIV-positive individuals are at no greater risk for depression than comparable HIV-negative individuals. This study used meta-analytic techniques to further examine the relationship between depressive disorders and HIV infection. Meta-analytic techniques were used to aggregate and reanalyze the data from 10 studies that compared HIV-positive and HIV-negative individuals for rates of major depressive disorder (N=2,596) or dysthymic disorder (N=1,822). The frequency of major depressive disorder was nearly two times higher in HIV-positive subjects than in HIV-negative comparison subjects. On the other hand, findings were inconclusive with regard to dysthymic disorder. Rates of depression do not appear to be related to the sexual orientation or disease stage of infected individuals. Although the majority of HIV-positive individuals appear to be psychologically resilient, this meta-analysis provides strong evidence that HIV infection is associated with a greater risk for major depressive disorder. Future research should focus on identifying pathways of risk and resilience for depression within this population.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                19 July 2012
                : 7
                : 7
                : e40793
                [1 ]British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada
                [2 ]Department of Psychiatry, University of California San Diego, San Diego, California, United States of America
                [3 ]Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
                [4 ]Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
                University of Nebraska Medical Center, United States of America
                Author notes

                Conceived and designed the experiments: VDL WZ RSH TLP JSGM. Performed the experiments: VDL RSH. Analyzed the data: WZ VDL. Contributed reagents/materials/analysis tools: NO WZ JIF VDL RSH. Wrote the paper: WZ NO JIF KAS. Statistical analysis: WZ VDL.

                Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                : 16 March 2012
                : 13 June 2012
                Page count
                Pages: 5
                Research Article
                Diagnostic Medicine
                Test Evaluation
                Infectious Diseases
                Sexually Transmitted Diseases
                Viral Diseases
                HIV clinical manifestations
                HIV epidemiology
                Mental Health
                Mood Disorders
                Non-Clinical Medicine
                Evidence-Based Medicine
                Health Services Research



                Comment on this article