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Published online March 12, 2008
Diabetes Care 31:1118-1119, 2008
DOI: 10.2337/dc07-2019
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Screening for Depressive Symptoms

Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a Multiethnic Group of Patients With Diabetes in Singapore

Dorit Stahl, MD1, Chee Fang Sum, FRCPE1, Shin Si Lum, BA2, Pei Hsiang Liow, MMED1, Yiong Huak Chan, PHD3, Swapna Verma, MD2, Hong Choon Chua, MMED2 and Siow Ann Chong, MMED2

1 Diabetes Centre, Alexandra Hospital, Singapore
2 Department of Clinical Research, Institute of Mental Health, Singapore
3 Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Corresponding author: Chee Fang Sum, Diabetes Centre, Alexandra Hospital, 378 Alexandra Road, Singapore 159964. E-mail: chee_fang_sum{at}alexhosp.com.sg

OBJECTIVE—We determined the reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) against the DSM-IV–based diagnostic inventory, Schedule for Clinical Assessment in Neuropsychiatry (SCAN), in a multiethnic sample of adult subjects with diabetes attending a diabetes center in Singapore.

RESEARCH DESIGN AND METHODS—A total of 522 subjects (74.7% Chinese, 11.1% Malay, and 14.2% Indian) completed culturally adapted versions of the CES-D; 291 subjects were administered the SCAN inventory.

RESULTS—The CES-D (cutoff score 16) showed high negative predictive values of more than 90% in all three ethnic groups. The prevalence of depressive symptoms (CES-D) and depression (SCAN) was significantly different between the Chinese and Indian subjects (CES-D 27.4 vs. 43.2%, P = 0.006); (SCAN 15.0 vs. 31.1%, P = 0.01).

CONCLUSIONS—The CES-D proved to be a reliable instrument for identifying patients with depressive symptoms in the multiethnic setting of this study.

Abbreviations: CES-D, Center for Epidemiologic Studies Depression Scale • SCAN, Schedule for Clinical Assessment in Neuropsychiatry


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