Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis
Table 2
CES-D scores by demographic and clinical characteristics, (SD).
Total CES-D score
Positive affect
Negative affect
Somatic symptoms
Interpersonal difficulty
Full sample
347
17.2 (10.4)
8.2 (3.2)
5.5 (4.6)
6.7 (4.2)
1.2 (1.5)
Age in years
Mean (SD): 45.1 (8.3)
Range: 22–77 years
<45 years
154
18.1 (10.2)
8.0 (3.2)
5.9 (4.6)
6.8 (4.0)
1.4 (1.5)
≥45 years
193
16.5 (10.5)
8.4 (3.2)
5.1 (4.6)
6.7 (4.3)
1.1 (1.4)
Gender
Male
231
16.2 (10.3)
8.4 (3.2)
5.2 (4.4)
6.4 (4.0)
1.1 (1.3)
Female
93
19.4 (10.7)
7.8 (3.3)
6.2 (5.1)
7.6 (4.6)
1.4 (1.6)
Transgender
23
18.1 (9.0)
7.7 (2.9)
5.4 (4.2)
6.6 (3.9)
2.0 (1.8)
Race
Black
140
16.5 (9.6)
8.1 (3.4)
4.8 (4.4)
6.4 (4.3)
1.4 (1.5)
White
140
16.7 (10.2)
8.4 (3.1)
5.7 (4.5)
6.5 (3.9)
1.0 (1.2)
Other
67
19.7 (11.9)
8.0 (3.0)
6.5 (5.0)
7.8 (4.5)
1.5 (1.7)
Education completed
<High school
56
21.2 (11.4)
7.6 (3.2)
6.9 (4.9)
8.1 (4.8)
1.8 (1.8)
High school
218
16.4 (9.8)
8.3 (3.2)
5.1 (4.5)
6.4 (4.0)
1.2 (1.4)
College
73
16.6 (10.5)
8.5 (3.2)
5.4 (4.7)
6.8 (3.9)
1.0 (1.3)
Income (/month)
<1,000
246
17.3 (10.4)
8.2 (3.2)
5.5 (4.6)
6.7 (4.3)
1.3 (1.5)
≥1,000
101
16.9 (10.4)
8.3 (3.3)
5.4 (4.6)
6.8 (3.9)
1.0 (1.4)
CD4+ T-cell count
329
<200 (cells/mm3)
59
18.4 (11.0)
8.3 (3.0)
5.7 (4.6)
7.3 (4.2)
1.7 (1.7)
≥200 (cells/mm3)
270
16.8 (10.3)
8.2 (3.3)
5.3 (4.6)
6.5 (4.2)
1.2 (1.5)
Viral load (copies/mL)
320
<10,000
253
16.1 (10.1)
8.4 (3.2)
5.0 (4.4)
6.3 (4.0)
1.1 (1.4)
≥10,000
67
20.0 (11.1)
7.9 (3.2)
6.7 (4.9)
7.6 (4.6)
1.7 (1.7)
Years since HIV diagnosis
<5
60
17.8 (11.3)
8.0 (3.3)
5.8 (5.3)
6.6 (4.7)
1.3 (1.7)
≥5
287
17.1 (10.2)
8.3 (3.2)
5.4 (4.5)
6.7 (4.1)
1.2 (1.4)
AIDS diagnosis
No
170
17.9 (10.6)
7.9 (3.4)
5.7 (4.8)
6.8 (4.3)
1.3 (1.6)
Yes
177
16.5 (10.2)
8.6 (2.9)
5.2 (4.4)
6.6 (4.0)
1.2 (1.4)
Antiretroviral therapy?
No
102
18.0 (10.6)
8.0 (3.3)
6.1 (4.8)
6.5 (4.3)
1.4 (1.7)
Yes
245
16.9 (10.3)
8.3 (3.2)
5.2 (4.5)
6.8 (4.1)
1.2 (1.3)
Taking antidepressant?
No
209
16.1 (10.0)
8.2 (3.2)
4.9 (4.4)
6.3 (4.0)
1.2 (1.4)
Yes
138
18.8 (10.8)
8.2 (3.2)
6.3 (4.9)
7.4 (4.4)
1.4 (1.6)
Illicit drug test result
346
Negative
316
16.9 (10.4)
8.4 (3.2)
5.4 (4.6)
6.7 (4.2)
1.2 (1.4)
Positive
30
20.9 (9.0)
6.7 (3.3)
6.5 (4.9)
7.3 (4.2)
1.8 (1.7)
Note. Nonparametric tests (Kruskal-Wallis and Mann-Whitney ) were used to compare the nonnormal distributions of CES-D scores across demographic and clinical groups. Higher scores indicate fewer and/or less frequent depressive symptoms; total CES-D scores ≥ 16 indicate need to seek clinical evaluation for depression. Not reverse coded; higher scores indicate more positive affect. Difference between the groups was significant (). Adults who did not complete high school differed from the other two groups (). Smaller sample due to missing laboratory or drug test data.
