Skip to main content

Advertisement

SpringerLink
Log in

A Comparison of Three Brief Depression Measures in an Acute Psychiatric Population: CES-D-10, QIDS-SR, and DASS-21-DEP

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

The CES-D-10, QIDS-SR, and DASS-21-DEP are brief self-report instruments for depression that have demonstrated strong psychometric properties in clinical and community samples. However, it is unclear whether any of the three instruments is superior for assessing depression and treatment response in an acute, diagnostically heterogeneous, treatment-seeking psychiatric population. The present study examined the relative psychometric properties of these instruments in order to inform selection of an optimal depression measure in 377 patients enrolled in a psychiatric partial hospital program. Results indicated that the three measures demonstrated good to excellent internal consistency and strong convergent validity. They also demonstrated fair to good diagnostic utility, although diagnostic cut-off scores were generally higher than in previous samples. The three measures also evidenced high sensitivity to change in depressive symptoms over treatment, with the QIDS-SR showing the strongest effect. The results of this study indicate that any of the three depression measures may satisfactorily assess depressive symptoms in an acute psychiatric population. Thus, selection of a specific assessment tool should be guided by the identified purpose of the assessment. In a partial hospital setting, the QIDS-SR may confer some advantages, such as correspondence with DSM criteria, greater sensitivity to change, and assessment of suicidality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.

  • Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10(2), 77–84.

    PubMed  Google Scholar 

  • Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181.

    Article  Google Scholar 

  • Barlow, D. H. (2005). What’s new about evidence-based assessment? Psychological Assessment, 17(3), 308–311.

    Article  PubMed  Google Scholar 

  • Beard, C., & Björgvinsson, T. (2013). Commentary on psychological vulnerability: an integrative approach. Journal of Integrative Psychotherapy, 23(3), 281–283.

    Article  Google Scholar 

  • Björgvinsson, T., Kertz, S. J., Bigda-Peyton, J. S., McCoy, K. L., & Aderka, I. M. (2013). Psychometric properties of the CES-D-10 in a naturalistic psychiatric sample. Assessment, 20(4), 429–436.

    Article  PubMed  Google Scholar 

  • Blais, M. A., Lenderking, W. R., Baer, L., deLorell, A., Peets, K., Leahy, L., & Burns, C. (1999). Development and initial validation of a brief mental health outcome measure. Journal of Personality Assessment, 73(3), 359–373.

    Article  PubMed  Google Scholar 

  • Boey, K. W. (1999). Cross-validation of a short form of the CES-D in Chinese elderly. International Journal of Geriatric Psychiatry, 14(8), 608–617.

    Article  PubMed  Google Scholar 

  • Bradley, K. L., Bagnell, A. L., & Brannen, C. L. (2010). Factorial validity of the center for epidemiological studies depression 10 in adolescents. Issues in Mental Health Nursing, 31(6), 408–412.

    Article  PubMed  Google Scholar 

  • Cheng, S.-T., & Chan, A. C. M. (2005). The center for epidemiologic studies depression scale in older Chinese: thresholds for long and short forms. International Journal of Geriatric Psychiatry, 20(5), 465–470.

    Article  PubMed  Google Scholar 

  • Cheng, S.-T., Chan, A. C. M., & Fung, H. H. (2006). Factorial structure of a short version of the center for epidemiologic studies depression scale. International Journal of Geriatric Psychiatry, 21(4), 333–336.

    Article  PubMed  Google Scholar 

  • Cheung, Y. B., Liu, K. Y., & Yip, P. S. F. (2007). Performance of the CES-D and its short forms in screening suicidality and hopelessness in the community. Suicide and Life-Threatening Behavior, 37(1), 79–88.

    Article  PubMed  Google Scholar 

  • Clara, I. P., Cox, B. J., & Enns, M. W. (2001). Confirmatory factor analysis of the depression-anxiety-stress scales in depressed and anxious patients. Journal of Psychopathology and Behavioral Assessment, 23(1), 61–67.

    Article  Google Scholar 

  • Doraiswamy, P. M., Bernstein, I. H., Rush, A. J., Kyutoku, Y., Carmody, T. J., Macleod, L., & Trivedi, M. H. (2010). Diagnostic utility of the quick inventory of depressive symptomatology (QIDS-C16 and QIDS-SR16) in the elderly. Acta Psychiatrica Scandinavica, 122(3), 226–234.

    Article  PubMed  Google Scholar 

  • Duffy, F. F., Chung, H., Trivedi, M., et al. (2008). Systematic use of patient-rated depression severity monitoring: is it helpful and feasible in clinical psychiatry? Psychiatric Services, 59, 1148–1154.

    Article  PubMed  Google Scholar 

  • Gilbody, S. M., House, A. O., & Sheldon, T. A. (2002). Psychiatrists in the UK do not use outcome measures. National Survey. British Journal of Psychiatry, 180, 101–103.

    Article  PubMed  Google Scholar 

  • Gloster, A. T., Rhoades, H. M., Novy, D., Klotsche, J., Senior, A., Kunik, M., & Stanley, M. A. (2008). Psychometric properties of the depression anxiety and stress scale-21 in older primary care patients. Journal of Affective Disorders, 110(3), 248–259.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362.

    Article  PubMed  Google Scholar 

  • Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, J., & Conde, D. (2009). Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.

    Article  PubMed Central  PubMed  Google Scholar 

  • Henry, J. D., & Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.

    Article  PubMed  Google Scholar 

  • Hopko, D. R., Reas, D. L., Beck, J. G., Stanley, M. A., Wetherell, J. L., Novy, D. M., & Averill, P. M. (2003). Assessing worry in older adults: confirmatory factor analysis of the penn state worry questionnaire and psychometric properties of an abbreviated model. Psychological Assessment, 15(2), 173–183.

    Article  PubMed  Google Scholar 

  • Hunsley, J., & Mash, E. J. (2005). Introduction to the special section on developing guidelines for the evidence-based assessment (EBA) of adult disorders. Psychological Assessment, 17(3), 251–255.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Traux, P. (1991). Clinical significance: a statistical approach to defining meaningful cheange in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Joiner, T. E., Jr., Walker, R. L., Pettit, J. W., Perez, M., & Cukrowicz, K. C. (2005). Evidence-based assessment of depression in adults. Psychological Assessment, 17(3), 267–277.

    Article  PubMed  Google Scholar 

  • Kertz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H., & Björgvinsson, T. (2012). Worry across diagnostic presentations: prevalence, severity, and associated symptoms in a partial hospital setting. Journal of Anxiety Disorders, 26, 126–133.

    Article  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., Williams, J. B., Monohan, P. O., & Löwe, B. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317–325.

    Article  PubMed  Google Scholar 

  • Lamoureux, B. E., Linardatos, E., Fresco, D. M., Bartko, D., Logue, E., & Milo, L. (2010). Using the QIDS-SR16 to identify major depressive disorder in primary care medical patients. Behavior Therapy, 41(3), 423–431.

    Article  PubMed  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measuremet of observer agreement for categorical data. Biometrics, 33(1), 159–174.

    Article  PubMed  Google Scholar 

  • Lee, A. E. Y., & Chokkanathan, S. (2008). Factor structure of the 10-item CES-D scale among community dwelling older adults in Singapore. International Journal of Geriatric Psychiatry, 23(6), 592–597.

    Article  PubMed  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995a). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.

    Article  PubMed  Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (1995b). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.

    Google Scholar 

  • Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care, 46(3), 266–274.

    Article  PubMed  Google Scholar 

  • Meng, X., Rosenthal, R., & Rubin D. B. (1992). Comparing correlated correlation coefficients. Psychological Bulletin, 172–175.

  • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the penn state worry questionnaire. Behaviour Research and Therapy, 28(6), 487–495.

    Article  PubMed  Google Scholar 

  • Myers. (2011). Goodbye, listwise deletion: presenting Hot deck imputation as an easy and effective tool for handling missing data. Communication Methods and Measures, 5, 297–310. doi:10.1080/19312458.2011.624490.

    Article  Google Scholar 

  • Ng, F., Trauer, T., Dodd, S., Callaly, T., Campbell, S., & Berk, M. (2007). The validity of the 21-item version of the depression anxiety stress scales as a routine clinical outcome measure. Acta Neuropsychiatrica, 19(5), 304–310.

    Article  Google Scholar 

  • Norton, P. J. (2007). Depression anxiety and stress scales (DASS-21): psychometric analysis across four racial groups. Anxiety, Stress & Coping: An International Journal, 20(3), 253–265.

    Article  Google Scholar 

  • Patrick, J., Dyck, M., & Bramston, P. (2010). Depression anxiety stress scale: is it valid for children and adolescents? Journal of Clinical Psychology, 66(9), 996–1007.

    PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  • Ronk, F. R., Korman, J. R., Hooke, G. R., & Page, A. C. (2014). Assessing clinical significance of treatment outcomes using the DASS-21. Psychological Assessment. doi:10.1037/a0033100.

    Google Scholar 

  • Rush, A. J., Gullion, C. M., Basco, M. R., & Jarrett, R. B. (1996). The inventory of depressive symptomatology (IDS): psychometric properties. Psychological Medicine, 26(3), 477–486.

    Article  PubMed  Google Scholar 

  • Rush, A. J., Carmody, T., & Reimitz, P.-E. (2000). The inventory of depressive symptomatology (IDS): clinician (IDS-C) and self-report (IDS-SR) ratings of depressive symptoms. Journal of Practical Psychiatry and Behavioral Health, 9, 45–59.

    Google Scholar 

  • Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., & Keller, M. B. (2003). The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54(5), 573–583.

    Article  PubMed  Google Scholar 

  • Rush, A. J., Trivedi, M. H., Carmody, T. J., Ibrahim, H. M., Markowitz, J. C., Keitner, G. I., & Keller, M. B. (2005). Self-reported depressive symptom measures: sensitivity to detecting change in a randomized, controlled trial of chronically depressed, nonpsychotic outpatients. Neuropsychopharmacology, 30(2), 405–416.

    Article  PubMed  Google Scholar 

  • Rush, A. J., Bernstein, I. H., Trivedi, M. H., Carmody, T. J., Wisniewski, S., Mundt, J. C., & Fava, M. (2006a). An evaluation of the quick inventory of depressive symptomatology and the Hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report. Biological Psychiatry, 59(6), 493–501.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rush, A. J., Carmody, T. J., Ibrahim, H. M., Trivedi, M. H., Biggs, M. M., Shores-Wilson, K., & Kashner, T. M. (2006b). Comparison of self-report and clinician ratings on two inventories of depressive symptomatology. Psychiatric Services, 57(6), 829–837.

    Article  PubMed  Google Scholar 

  • Shao, J., & Zhong, B. (2003). Last observation carry- forward and last observation analysis. Statistics in Medicine, 22, 2429–2441.

    Article  PubMed  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Janavs, J., Weiller, E., Keskiner, A., & Dunbar, G. C. (1997). The validity of the mini international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. European Psychiatry, 12(5), 232–241.

    Article  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., & Dunbar, G. C. (1998). The mini-international neuropsychiatric interview (M.I.N.I): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33.

    PubMed  Google Scholar 

  • Slade, M., McCrone, P., Kuipers, E., et al. (2006). Use of standardised outcome measures in adult mental health services: randomised controlled trial. British Journal of Psychiatry, 189, 330–336.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2004). Using multivariate statistics (5th ed.). Boston: Pearson Publications.

    Google Scholar 

  • Trivedi, M. H., Rush, A. J., Ibrahim, H. M., Carmody, T. J., Biggs, M. M., Suppes, T., & Kashner, T. M. (2004). The inventory of depressive symptomatology, clinician rating (IDS-C) and self-report (IDS-SR), and the quick inventory of depressive symptomatology, clinician rating (QIDS-C) and self-report (QIDS-SR) in public sector patients with mood disorders: a psychometric evaluation. Psychological Medicine, 34(1), 73–82.

    Article  PubMed  Google Scholar 

  • Uher, R., Perlis, R. H., Placentino, A., Dernovšek, M. Z., Henigsberg, N., Mors, O., Maier, W., Mcguffin, P., & Farmer, A. (2012). Self-report and clinician-rated measures of depression severity: can one replace the other? Depression and Anxiety, 29(12), 1043–1049.

    Article  PubMed Central  PubMed  Google Scholar 

  • Weiss, A. P., Guidi, J., & Fava, M. (2009). Closing the efficacy-effectiveness gap: translating both the what and the how from randomized controlled trials to clinical practice. Journal of Clinical Psychiatry, 70, 446–449.

    Article  PubMed  Google Scholar 

  • Wood, B. M., Nicholas, M. K., Blyth, F., Asghari, A., & Gibson, S. (2010). The utility of the short version of the depression anxiety stress scales (DASS-21) in elderly patients with persistent pain: does age make a difference? Pain Medicine, 11(12), 1780–1790.

    Article  PubMed  Google Scholar 

  • Young, J. L., Waehler, C. A., Laux, J. M., McDaniel, P. S., & Hilsenroth, M. J. (2003). Four studies extending the utility of the Schwartz outcome scale (SOS-10). Journal of Personality Assessment, 80(2), 130–138.

    Article  PubMed  Google Scholar 

  • Zimmerman, M., & McGlinchey, J. B. (2008). Why don’t psychiatrists use scales to measure outcome when treating depressed patients? Journal of Clinical Psychiatry, 68, 1916–1919.

    Article  Google Scholar 

Download references

Conflict of Interest

There are no conflicts of interest to disclose.

Experiment Participants

The study was approved by the Institutional Review Board and all participants provided written informed consent.

Author information

Authors and Affiliations

  1. McLean Hospital/Harvard Medical School, 115 Mill St., Belmont, MA, 02478, USA

    Rachel B. Weiss, Idan M. Aderka, Josephine Lee, Courtney Beard & Thröstur Björgvinsson

  2. Department of Psychology, University of Haifa, Mt. Carmel, 31905, Israel

    Idan M. Aderka

Authors
  1. Rachel B. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Idan M. Aderka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Josephine Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Courtney Beard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thröstur Björgvinsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel B. Weiss.

Appendix

Appendix

Table 5 Inter-Item Correlations of the CES-D
Full size table
Table 6 Inter-Item Correlations of the QIDS-SR
Full size table
Table 7 Inter-Item Correlations of the DASS-21
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Weiss, R.B., Aderka, I.M., Lee, J. et al. A Comparison of Three Brief Depression Measures in an Acute Psychiatric Population: CES-D-10, QIDS-SR, and DASS-21-DEP. J Psychopathol Behav Assess 37, 217–230 (2015). https://doi.org/10.1007/s10862-014-9461-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-014-9461-y

Keywords

Search

Navigation