Poulin Christiane, Hand Denise, Boudreau Brock
Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada.
Chronic Dis Can. 2005 Spring-Summer;26(2-3):65-72.
This validation study assessed the degree of confidence that can be placed on inferences from depressive symptoms among adolescents, based on a 12-item version of the Centre for Epidemiological Studies Depression scale (CES-D). This short version of the scale had been developed for application in the National Longitudinal Study of Children and Youth and we refer to it as the CES-D-12-NLSCY. The major data source for the present validation study was a 2002/2003 survey of 12,990 students in junior and senior high school in the Atlantic provinces of Canada. Receiver operating characteristic curve analyses for two different proxy gold standards yielded adequate areas under the curve (AUCs) of .84 and .80, allowing us to establish cut points for three categories of depressive symptoms in the general adolescent population: Minimal (CES-D-12-NLSCY total score 0 to 11), Somewhat Elevated (total score 12 to 20) and Very Elevated (total score 21 to 36). The CES-D-12-NLSCY was found to have acceptable internal consistency (Cronbach=s alpha .85). All but one of the 12 items of the CES-D-12-NLSCY were found to have acceptable discrimination ability. The prevalence of Minimal, Somewhat and Very Elevated depressive symptoms in the adolescent student population of the Atlantic provinces was estimated to be 72.3, 19.5 and 5.5 percent, respectively. A further 2.6 percent of students who responded to fewer than 11 items of the scale were classified as Indeterminate with regards to depressive symptom category. The major threat to the accuracy of the CES-D-12-NLSCY is its lack of inquiry about irritability, which is a key symptom of depression in youth.
这项验证研究基于流行病学研究中心抑郁量表（CES - D）的12项版本，评估了从青少年抑郁症状推断中可获得的置信度。该量表的这个简短版本是为在全国儿童和青少年纵向研究中应用而开发的，我们将其称为CES - D - 12 - NLSCY。本验证研究的主要数据来源是2002/2003年对加拿大大西洋省份12990名初中生和高中生进行的一项调查。针对两种不同的替代金标准进行的接受者操作特征曲线分析得出了足够的曲线下面积（AUC），分别为0.84和0.80，这使我们能够为一般青少年人群中的三类抑郁症状确定切点：轻度（CES - D - 12 - NLSCY总分0至11）、中度升高（总分12至20）和重度升高（总分21至36）。发现CES - D - 12 - NLSCY具有可接受的内部一致性（克朗巴赫α系数为0.85）。CES - D - 12 - NLSCY的12个项目中除一项外，其他项目都具有可接受的区分能力。据估计，大西洋省份青少年学生人群中轻度、中度和重度抑郁症状的患病率分别为72.3%、19.5%和5.5%。另外，对量表少于11个项目做出回应的学生中有2.6%在抑郁症状类别方面被归类为不确定。CES - D - 12 - NLSCY准确性的主要威胁在于它没有询问易怒情绪，而易怒是青少年抑郁症的关键症状。
