Depression is far more than just a "bad mood" — it's a significant medical condition where persistent feelings of sadness, fatigue, or hopelessness interfere with a person's daily life. Many people experience depressive symptoms due to chronic stress, illness, major life changes, or biochemical factors. To help identify these symptoms, the CES-D (Center for Epidemiologic Studies Depression Scale) was developed as a quick screening tool. It is crucial to understand that this scale does not provide a diagnosis but rather indicates whether you have symptoms that warrant a consultation with a mental health professional.

The scale was developed in 1977 by its author, Lenore Sawyer Radloff, for the National Institute of Mental Health (NIMH) in the United States. The primary goal was straightforward: to create a reliable tool for tracking depressive symptoms in the general population for large-scale research, not just within clinical settings. The test's questions are based on symptoms from other well-established scales, such as Beck's Depression Inventory and Zung's Self-Rating Depression Scale. It specifically focuses on how you have felt over the past week. This one-week timeframe is intentional because depressive moods can fluctuate, and this short period provides an accurate snapshot of a person's current state. Interestingly, among the 20 questions, four are framed positively — asking about feelings of joy, hope, or self-worth. This is a deliberate design choice to prevent response bias and to assess for the absence of positive affect, which is also a key symptom of depression.

The CES-D has been validated across thousands of individuals from diverse backgrounds: from healthy people to patients with chronic conditions like heart disease or cancer, and across all age groups. It is known to be highly reliable, with a Cronbach’s alpha (a measure of internal consistency) typically around 0.85. Its validity has also been consistently confirmed, as it effectively distinguishes between individuals with clinical depression and those without. In psychology and epidemiology, it is often considered a "gold standard" for population-based screening because it is simple, fast, and free to use. Furthermore, studies have shown that the CES-D remains effective even for individuals with mild cognitive impairments, as the questions are clear and easy to understand.

Take the Test Yourself

Think about the past week and consider how often you have felt the way described in each statement. For each one, choose the number that best corresponds to your feelings:

• 0: Rarely or none of the time (less than 1 day)
• 1: Some or a little of the time (1-2 days)
• 2: Occasionally or a moderate amount of the time (3-4 days)
• 3: Most or all of the time (5-7 days)

1. I was bothered by things that usually don’t bother me.
2. I did not feel like eating; my appetite was poor.
3. I felt that I could not shake off the blues even with help from my family or friends.
4. I felt that I was just as good as other people.
5. I had trouble keeping my mind on what I was doing.
6. I felt depressed.
7. I felt that everything I did was an effort.
8. I felt hopeful about the future.
9. I thought my life had been a failure.
10. I felt fearful.
11. My sleep was restless.
12. I was happy.
13. I talked less than usual.
14. I felt lonely.
15. People were unfriendly.
16. I enjoyed life.
17. I had crying spells.
18. I felt sad.
19. I felt that people disliked me.
20. I could not get “going.”

How to Calculate Your Score

To calculate your total score, first sum the values you selected for each of the 20 items. However, for the four positive items (items 4, 8, 12, and 16), you must reverse the scores before adding them. Use the following conversion for those four items only:

• If you chose 0, change it to 3.
• If you chose 1, change it to 2.
• If you chose 2, change it to 1.
• If you chose 3, change it to 0.

After reversing the scores for those four items, add up the final values for all 20 questions. The total score will range from 0 to 60. If you skipped more than 4 questions, the result may not be accurate.

What Your Score Means

• 0–15: Mild or no symptoms. A score in this range suggests you are likely experiencing few to no depressive symptoms. However, it is always wise to monitor your mental well-being.
• 16 or higher: High risk of depression. A score of 16 or above is considered the clinical cutoff and indicates that your symptoms are significant enough to be interfering with your life. This score is a strong signal that you should seek a consultation with a qualified professional, such as a psychologist, psychiatrist, or general practitioner. Remember, the test is a screener, not a diagnosis, but it effectively flags a potential problem. Studies show that a cutoff score of 16 correctly identifies about 70% of individuals with clinical depression while also flagging about 20% of the general population who may be at risk.

A key feature of the CES-D is its sensitivity to change — scores have been shown to rise after stressful life events, like a divorce, and fall in response to effective treatment. This makes it a valuable tool for monitoring public mental health during large-scale crises, such as pandemics or wars. If your score is high, consider practical steps like improving sleep, increasing physical exercise, or talking to a trusted friend or family member. While these actions can help, they are not a substitute for professional evaluation and treatment.

References

• 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.