Data from five psychiatric populations and a community sample are presented on the CES-D, 20-item self-report depression symptom scale developed by the Center for Epidemiologic Studies. Results show that the scale is a sensitive tool for detecting depressive symptoms and change in symptoms over time in psychiatric populations, and that it agrees quite well with more lengthy self-report scales used in clinical studies and with clinician interview ratings. Although a symptom scale cannot differentiate between diagnositc groups, the CES-D has demonstrated its validity as a screening tool for detecting depressive symptoms in psychiatric populations.
The associations between the one-month prevalence rates of mental disorders and sociodemographic characteristics were investigated for 18,571 people interviewed in the first-wave community samples of all 5 sites in the US National Institute of Mental Health (NIMH) Epidemiologic Catchment Area program. Men were found to have a significantly higher rate of cognitive impairment than women after controlling for the effects of age, race or ethnicity, marital status and socioeconomic status. Marital status was one of the most powerful correlates of mental disorder risk: the odds of separated or divorced people having any NIMH Diagnostic Interview Schedule disorder were twice that of married people after controlling for age, gender, race or ethnicity and socioeconomic status. The odds of those in the lowest socioeconomic status group having any Diagnostic Interview Schedule disorder was about 2.5 times that of those in the highest socioeconomic status group, controlling for age, gender, race or ethnicity and marital status. For all disorders except cognitive impairment, race or ethnicity did not remain statistically significant after controlling for age, gender, marital status and socioeconomic status.
The relation between self-reported physical activity and depressive symptoms was analyzed for 1,900 healthy subjects aged 25-77 years in the Epidemiologic Follow-up Study (1982-1984) to the first National Health and Nutrition Examination Survey (NHANES I). Depressive symptomatology as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) was examined by sex and race in relation to recreational physical activity and physical activity apart from recreation, controlling for age, education, income, employment status, and chronic conditions. Little or no recreational physical activity and little or no physical activity apart from recreation were cross-sectionally associated with depressive symptoms in whites and in blacks. After exclusion of those with depressive symptoms at baseline, recreational physical activity was an independent predictor of depressive symptoms an average of eight years later in white women. The adjusted odds of depressive symptoms at follow-up were approximately 2 for women with little or no recreational physical activity compared with women with much or moderate recreational physical activity (95% confidence interval 1.1-3.2). These findings are the first indication from a prospective study of a large community sample that physical inactivity may be a risk factor for depressive symptoms.
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