## 06.08CESD-R Explanation

**Using the CESD-R:**

The CESD-R is in the public domain so it is free to use in your research.

*Below is an explanation of the algorithm used to calculate the depression scores and categories, intended for researchers who may want to use the CESDR.*

The 20 items in CESDR scale measure symptoms of depression in nine different groups as defined by the American Psychiatric Association Diagnostic and Statistical Manual, fifth edition. These symptom groups are shown below, with their associated scale question numbers to the right.

**Sadness**(Dysphoria): Question numbers 2,4, 6**Loss of Interest**(Anhedonia): Question numbers 8, 10**Appetite:**Question numbers 1, 18**Sleep:**Question numbers 5, 11, 19**Thinking / concentration:**Question numbers 3, 20**Guilt**(Worthlessness): Question numbers 9, 17**Tired**(fatigue): Question numbers 7, 16**Movement**(Agitation): Question numbers 12, 13**Suicidal ideation:**Question numbers 14, 15

Calculating the overall CESD-style symptom score

The response values for each question are:

- Not at all or less than one day = 0
- 1-2 days = 1
- 3-4 days = 2
- 5-7 days = 3
- Nearly every day for 2 weeks = 4

The Total CESD-R Score is calculated as a sum of responses to all 20 questions. In order to make the revised CESD-R have the same range as the original version i.e., the ‘CESD style score’), the values for the top two responses are given the same value:

- Not at all or less than one day = 0
- 1-2 days = 1
- 3-4 days = 2
- 5-7 days = 3
- Nearly every day for 2 weeks = 3

As in the original CESD the range of possible scores is between 0 (for those who say ‘not at all or less than one day to all 20 questions’ and 60 (for those who say ‘5-7 days’ or ‘nearly every day for 2 weeks’ for all 20 questions).

Determining categories

The determination of possible depressive symptom category is based upon an algorithm with the following logic:

**Meets criteria for Major depressive episode**: Anhedonia or dysphoria nearly every day for the past two weeks, plus symptoms in an additional 4 DSM symptom groups noted as occurring nearly every day for the past two weeks;

**Probable major depressive episode**: Anhedonia or dysphoria nearly every day for the past two weeks, plus symptoms in an additional 3 DSM symptom groups reported as occurring either nearly every day for the past two weeks, or 5-7 days in the past week;

**Possible major depressive episode**: Anhedonia or dysphoria nearly every day for the past two weeks, plus symptoms in an additional 2 other DSM symptom groups reported as occurring either nearly every day for the past two weeks, or 5-7 days in the past week;

**Subthreshhold depression symptoms**: People who have a CESD-style score of at least 16 but do not meet above criteria;**No clinical significance**: People who have a total CESD-style score less than 16 across all 20 questions.