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Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis

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dc.contributor.author Vilagut Saiz, Gemma, 1975-
dc.contributor.author Forero, Carlos G.
dc.contributor.author Barbaglia, María Gabriela, 1979-
dc.contributor.author Alonso Caballero, Jordi
dc.date.accessioned 2016-06-17T13:06:59Z
dc.date.available 2016-06-17T13:06:59Z
dc.date.issued 2016
dc.identifier.citation Vilagut G, Forero CG, Barbaglia G, Alonso J. Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis. PLoS One. 2016; 11(5): e0155431. DOI 10.1371/journal.pone.0155431
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/26944
dc.description.abstract OBJECTIVE: We aimed to collect and meta-analyse the existing evidence regarding the performance of the Center for Epidemiologic Studies Depression (CES-D) for detecting depression in general population and primary care settings./nMETHOD: Systematic literature search in PubMed and PsychINFO. Eligible studies were: a) validation studies of screening questionnaires with information on the accuracy of the CES-D; b) samples from general populations or primary care settings; c) standardized diagnostic interviews following standard classification systems used as gold standard; and d) English or Spanish language of publication. Pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratio were estimated for several cut-off points using bivariate mixed effects models for each threshold. The summary receiver operating characteristic curve was estimated with Rutter and Gatsonis mixed effects models; area under the curve was calculated. Quality of the studies was assessed with the QUADAS tool. Causes of heterogeneity were evaluated with the Rutter and Gatsonis mixed effects model including each covariate at a time. RESULTS: 28 studies (10,617 participants) met eligibility criteria. The median prevalence of Major Depression was 8.8% (IQ range from 3.8% to 12.6%). The overall area under the curve was 0.87. At the cut-off 16, sensitivity was 0.87 (95% CI: 0.82-0.92), specificity 0.70 (95% CI: 0.65-0.75), and DOR 16.2 (95% CI: 10.49-25.10). Better trade-offs between sensitivity and specificity were observed (Sensitivity = 0.83, Specificity = 0.78, diagnostic odds ratio = 16.64) for cut-off 20. None of the variables assessed as possible sources of heterogeneity was found to be statistically significant. CONCLUSION: The CES-D has acceptable screening accuracy in the general population or primary care settings, but it should not be used as an isolated diagnostic measure of depression. Depending on the test objectives, the cut-off 20 may be more adequate than the value of 16, which is typically recommended.
dc.description.sponsorship This study is supported by a grant from Instituto de Salud Carlos III FEDER, (PI08/90724) and from the DIUE of the Generalitat de Catalunya, Spain (2014 SGR 748; 2009 SGR 1095). Gemma Vilagut was supported by “Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (ISCIII)” (ECA07/059); Carlos G. Forero was supported by “Ministerio de Ciencia e Innovación”, FSE (JCI-2009-05486); Gabriela Barbaglia was supported by “Ministerio de Ciencia e Innovación” Rio Hortega grant (CM 10-00099), Spain.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartof PLoS One. 2016; 11(5): e0155431
dc.rights © 2016 Vilagut et al. 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 credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.other Depressió psíquica -- Diagnòstic
dc.title Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0155431
dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/JCI-2009-05486
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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