In terms of translation, various locally developed versions of the CES-D exist, however those that have been published and used in adult samples have had weak conceptual equivalence to the original English version for modern Hong Kong Chinese. A more recent study sampled school-aged Chinese adolescents who may possess unique conceptualizations of depressive symptomatology due to the complexities of adolescence. One study incorporated a selected sample of married couples with sample size insufficient for the statistical methods applied. In the Hong Kong setting, previous studies examining the psychometric properties of the CES-D have used methods which limit its applicability and generalizability. Despite its widespread use, the psychometric properties of the CES-D have only been tested in selective Chinese samples. The CES-D has also been used in a variety of Chinese populations including Chinese in America, Chinese in Hong Kong, Chinese in Mainland China and Chinese in Taiwan. The CES-D, which was developed by Radloff, has been widely used in different age groups including adolescents, adults, and the elderly and patient populations such as cancer patients and patients with heart disease. According to Shafer, the CES-D is a balanced and comprehensive instrument and is the only instrument which assesses interpersonal aspects. The Center for Epidemiologic Studies Depression Scale (CES-D) is one of the more frequently used screening instruments for depressive symptoms. Thus, the detection of depressive symptoms and provision of treatments are of paramount importance to diminish the negative impacts of depressive disorders on individuals and society as a whole. At its worst, depressive symptoms can lead to suicide. Weng Yee Chin (e-mail: This work was supported by the Food and Health Bureau Hong Kong SAR Commissioned Research on Mental Health Policy and Service Ref SMH-27.Ĭompeting interests: The authors have declared that no competing interests exist.ĭepressive disorders are disabling impairing people’s functioning and health-related quality of life (HRQOL). To request the data, please contact the corresponding author Dr. The data set contains patients’ personal information and clinical data. 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 creditedĭata Availability: The data cannot be made available in the manuscript, the supplemental files, or a public repository due to ethical restrictions. Received: ApAccepted: JPublished: August 7, 2015Ĭopyright: © 2015 Chin et al. PLoS ONE 10(8):Įditor: Joseph Chilcot, Kings College, UNITED KINGDOM The CES-D was externally responsive, with the AUC>0.7.Ĭitation: Chin WY, Choi EPH, Chan KTY, Wong CKH (2015) The Psychometric Properties of the Center for Epidemiologic Studies Depression Scale in Chinese Primary Care Patients: Factor Structure, Construct Validity, Reliability, Sensitivity and Responsiveness. Internal responsiveness of the CES-D to detect positive and negative changes was satisfactory (with p value 0.2). The CES-D was sensitive in detecting differences between known groups, with the AUC >0.7. For the two-week test-retest reliability, the intraclass correlation coefficient was 0.91. The ωH values for “somatic”, “depressed affect”, “positive affect” and “interpersonal problems” were 0.434, 0.038, 0.738 and 0.730, respectively. The ωH value for the general depression factor was 0.855. Internal consistency was assessed by McDonald’s omega hierarchical (ωH). The CES-D had a strong correlation with the PHQ-9 (coefficient: 0.78) and SF-12 v2 MCS (coefficient: -0.75). The convergent validity was assessed by examining the correlations between the CES-D, the Patient Health Questionnaire 9 (PHQ-9) and the Short Form-12 Health Survey (version 2) Mental Component Summary (SF-12 v2 MCS). For the internal construct validity, corrected item-total correlations were 0.4 for most items. The original CES-D four-structure model had adequate fit, however the data was better fit into a bi-factor model. Three competing factor structure models were examined using confirmatory factor analysis. The psychometric properties were assessed amongst a sample of 3686 Chinese adult primary care patients in Hong Kong.