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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00315

The reliability and validity of The Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese university students

Lijun Jiang1,  Ying Wang2, Yining Zhang3, Rui Li3,  Huailiang Wu3, Chenyi Li3, Yunlin Wu3 and  Qian Tao1*
  • 1Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, China
  • 2Medical Imaging Center, First Affiliated Hospital of Jinan University, China
  • 3International School, Jinan University, China

Aims: Depression is prevalent among university students worldwide, and the prevalence appears to be increasing. As an intermediate stage between healthy and depression, students with subthreshold depression could develop worsening depression or be recovered with intervention to prevent depression. The Center for Epidemiologic Studies Depression Scale (CES-D) is a useful tool to assess subthreshold depression. The primary purpose of the current study was to evaluate the psychometric characteristics of CES-D in Chinese university students. Secondly, we aimed to describe the prevalence of subthreshold depression among the student sample and examine its demographic correlates.
Methods: A total of 2,068 university students participated in the study, and they were asked to respond to the Chinese CES-D, Beck Depression Inventory-II (BDI-II), and Positive and Negative Affect Schedule (PANAS). The reliability was assessed by calculating Cronbach's α, inter-item correlation, and item-total correlation coefficients. The factor structure was evaluated by conducting exploratory (EFA) and confirmatory factor analysis (CFA) using a structural equation modeling approach. The prevalence of subthreshold depression was calculated and the demographic correlates of gender, grade, and major were examined by multiple regression.
Results: The final sample included 1,920 participants. The prevalence of subthreshold depression among university students reached 32.7% with a cut-off score of 20 for the 20-item CES-D and 31% with a cut-off of 16 for the 14-item CES-D, although there was no significant difference of prevalence in gender, grade, and major. The EFA results suggested extraction of three factors (somatic symptoms, negative affect, and anhedonia) that account for 52.68% of total variance. The CFA results suggested that the newly derived model with 14 items was the best fit with our data. Six items were finally removed from the original scale (item 9, 10, 13, 15, 17 and 19). The Cronbach’s alpha of the 14-item CES-D was 0.87.
Conclusions: The CES-D has good reliability and validity for assessing subthreshold depression in Chinese university students.

Keywords: validity, Reliability, Students, Depression, CES-D

Received: 27 Feb 2019; Accepted: 24 Apr 2019.

Edited by:

Menachem Ben-Ezra, Ariel University, Israel

Reviewed by:

Nuno Madeira, Faculty of Medicine, University of Coimbra, Portugal
Forough Mortazavi, Sabzevar University of Medical Sciences, Iran  

Copyright: © 2019 Jiang, Wang, Zhang, Li, Wu, Li, Wu and Tao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Qian Tao, Jinan University, Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangzhou, 510632, Guangdong Province, China,