Center for Epidemiologic Studies Depression Scale (CES-D)

The Center for Epidemiologic Studies Depression Scale (CES-D) is a short self-report screen for depressive symptoms in the past week. It was built at the National Institute of Mental Health for population surveys, which is why it emphasizes how often symptoms occurred rather than clinical history.

Twenty items ask how many days in the past week the person felt a particular way — bothered by things that usually don't bother them, unable to shake the blues, that everything was an effort. Each is rated 0 to 3, from rarely or none of the time to most or all of the time, for a total from 0 to 60. Four positively worded items are reverse-scored. A total of 16 or higher is the commonly used threshold for elevated symptoms.

Licensing Notes: The scale is widely described as free for clinical and research use. No fee or licensing agreement is required for the standard version.

Learn More: The four positively worded items exist for two reasons: they catch careless responding, and they capture positive affect as its own dimension. The 16 cut-point was validated in community samples, and some research suggests it may be too low for older adults, producing false positives — worth knowing before applying it in a skilled nursing setting.