Screening for depression in the general population with the center for epidemiologic studies depression (CES-D): a systematic review with meta-analysis
Author
Vilagut, Gemma
Forero, Carlos G.
Barbaglia, Gabriela
Alonso, Jordi
Publication date
2016ISSN
1932-6203
Abstract
Objective: We aimed to collect and meta-analyse the existing evidence regarding the performance of the Center for Epidemiologic Studies Depression (CES-D) for detecting depression in general population and primary care settings. Method: Systematic literature search in PubMed and PsychINFO. Eligible studies were: a) validation studies of screening questionnaires with information on the accuracy of the CES-D; b) samples from general populations or primary care settings; c) standardized diagnostic interviews following standard classification systems used as gold standard; and d) English or Spanish language of publication. Pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratio were estimated for several cut-off points using bivariate mixed effects models for each threshold. The summary receiver operating characteristic curve was estimated with Rutter and Gatsonis mixed effects models; area under the curve was calculated. Quality of the studies was assessed with the QUADAS tool. Causes of heterogeneity were evaluated with the Rutter and Gatsonis mixed effects model including each covariate at a time. Results: 28 studies (10,617 participants) met eligibility criteria. The median prevalence of Major Depression was 8.8% (IQ range from 3.8% to 12.6%). The overall area under the curve was 0.87. At the cut-off 16, sensitivity was 0.87 (95% CI: 0.82–0.92), specificity 0.70 (95% CI: 0.65–0.75), and DOR 16.2 (95% CI: 10.49–25.10). Better trade-offs between sensitivity and specificity were observed (Sensitivity = 0.83, Specificity = 0.78, diagnostic odds ratio = 16.64) for cut-off 20. None of the variables assessed as possible sources of heterogeneity was found to be statistically significant. Conclusion: The CES-D has acceptable screening accuracy in the general population or primary care settings, but it should not be used as an isolated diagnostic measure of depression. Depending on the test objectives, the cut-off 20 may be more adequate than the value of 16, which is typically recommended.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
159.9 - Psychology
Keywords
Depressió
Centre d’Estudis Epidemiològics sobre Depressió
Atenció primària
Depresión
Centro de Estudios Epidemiológicos sobre Depresión
Atención primaria
Depression
Center for Epidemiological Studies on Depression
Primary care
Pages
17
Publisher
Public Library of Science
Collection
11; 5
Is part of
PLoS ONE
Citation
Vilagut, Gemma; Forero, Carlos G.; Barbaglia, Gabriela [et al.]. Screening for depression in the general population with the center for epidemiologic studies depression (CES-D): a systematic review with meta-analysis. PLoS ONE, 2016, 11(5), e0155431. Disponible en: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155431>. Fecha de acceso: 14 sep. 2021. DOI: 10.1371/journal.pone.0155431
This item appears in the following Collection(s)
- Ciències de la Salut [745]
Rights
© 2016 Vilagut 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.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/