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Psychometric validation of the Center for Epidemiological Studies Depression Scale in Head and Neck Cancer patients
Journal article   Peer reviewed

Psychometric validation of the Center for Epidemiological Studies Depression Scale in Head and Neck Cancer patients

K. S. Chhabria and G. D. Carnaby
Oral oncology, Vol.75, pp.158-162
12/01/2017
DOI: https://doi.org/10.1016/j.oraloncology.2017.11.010
PMID: 29224813
Web of Science ID: WOS:000417555400025

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Abstract

Objective: 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. Methods: 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. Results: The sample was predominantly male receiving chemo radiation. Face validity was strong (alpha = 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 (alpha= 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. Conclusion: 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.

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