Measures of Depression as a Clinical Disorder
Summary prepared by Sheldon Cohen in collaboration with the
Psychosocial Working Group. Last revised October, 1998.
Chapter Contents:
a. Definition and Background
b. Measurement
c. Relation to SES
d. Relationship to Health
e. Limitations
f. Conclusions
g. Selected Bibliography
Definition and Background
The gold standard for a research diagnosis of depression is the
Structural Clinical Interview (SCID), a clinical interview that uses the
DSM-III-R criteria for illness. However, because of the time and expense
required to administer a clinical interview, epidemiologic type studies
often use clinical interviews designed for administration by lay
interviewers (Composite International Diagnostic Interview [CIDI] or the
Diagnostic Interview Schedule [DIS]) or self-report questionnaires that
measure symptoms and mood rather than illness and disorder. We will
describe the SCID interview, as well as two of the most popular self-
report measures, the Center for Epidemiological Study of Depression
Scale (CES-D), and the Beck Depression Inventory (BDI). There are,
however, a number of other self-report scales one might consider
including the HRSD, the Zung, the MMPI-D scale, and the MAACL-D
scale.
Measurement
The SCID is a semi-structured interview for making the major Axis I
DSM-III-R diagnoses. It is administered by a clinician and includes an
introductory overview followed by nine modules, seven of which
represent the major axis I diagnostic classes. Because of its modular
construction, it can by adapted for use in studies in which particular
diagnoses (e.g., depression only) are of interest. The output of the SCID
is recorded as the presence or absence of each of the disorders being
considered, for current episode (past month) and for lifetime occurrence.
The reader is referred to Spitzer et al. (1992) and Williams et al. (1992)
for more detailed information about the interview and its psychometrics.
The Composite International Diagno