Department of Behavioral Science & Community Health, University of Florida, USA.
Department of Communication Sciences & Disorders, University of Central Florida, USA.
Oral Oncol. 2017 Dec;75:158-162. doi: 10.1016/j.oraloncology.2017.11.010. Epub 2017 Nov 15.
The Center for Epidemiological Studies Depression Scale (CES-D) is a 20-item tool developed to screen for depression in the general population. To psychometrically evaluate and validate the CES-D scale for use in head and neck cancer (HNC) patients.
The CES-D was applied to 130 subjects at onset of radiation treatment and 3-months following treatment. Analysis was conducted via face and content validity using two expert raters, internal consistency was applied using Cronbach's alpha, test retest reliability comparing baseline to 3-month application, concurrent validity was performed against the FACT-H&N and Pain Disability Index, construct validity was conducted via exploratory factor analysis.
The sample was predominantly male receiving chemo radiation. Face validity was strong (α = 0.85). Significant difference was found in the mean score between depressed (CES-D cut point ≥ 16) vs. non-depressed (t = -15.84, p = .00) (95% CI = -17.18, -13.33). Internal consistency of the scale was high (α = 0.84). Test retest reliability (p < .001) showed moderate-strong correlations (0.51), however was not sensitive to change in this sample across the study time period. Concurrent validity was strong (r = -0.77, 0.51). Factor analysis at baseline explained 54.92% of variance, with 3 distinct factors; depressed affect, somatic/retarded activity, and positive affect. In contrast to general populations, the factor 'disturbed interpersonal skill' was not retained.
Results confirm the reliability and validity of the CES-D as a measure of depression in HNC populations. Proposed cut off scores remain stable but scale responsiveness suggests caution when evaluating change over time in this population.
流行病学研究抑郁量表（CES-D）是一种 20 项工具，用于筛查普通人群中的抑郁症。对 CES-D 量表进行心理测量学评估和验证，以用于头颈部癌症（HNC）患者。
在开始放射治疗时和治疗后 3 个月，对 130 名患者应用 CES-D。通过两位专家评估者进行表面和内容效度分析，使用 Cronbach's alpha 进行内部一致性分析，比较基线和 3 个月应用的测试重测信度，与 FACT-H&N 和疼痛残疾指数进行同时效度，通过探索性因子分析进行结构效度。
样本主要为接受化疗放疗的男性。表面效度很强（α=0.85）。在抑郁（CES-D 切点≥16）与非抑郁（t=-15.84，p=0.00）之间的平均得分存在显著差异（95%CI=-17.18，-13.33）。量表的内部一致性很高（α=0.84）。测试重测信度（p<0.001）显示中度-强相关性（0.51），但在本研究时间段内，该样本的变化不敏感。同时效度很强（r=-0.77，0.51）。基线时的因子分析解释了 54.92%的方差，有 3 个不同的因子；抑郁情绪、躯体/迟缓活动和积极情绪。与一般人群不同，“人际技能障碍”这一因子未被保留。
结果证实 CES-D 作为 HNC 人群抑郁测量工具的可靠性和有效性。建议的截断分数保持稳定，但量表的反应性表明在评估该人群随时间的变化时需谨慎。
