TY - JOUR
T1 - Validation of the Center for Epidemiologic Studies Depression Scale in screening for major depressive disorder among retired firefighters exposed to the World Trade Center disaster
AU - Chiu, Sydney
AU - Webber, Mayris P.
AU - Zeig-Owens, Rachel
AU - Gustave, Jackson
AU - Lee, Roy
AU - Kelly, Kerry J.
AU - Rizzotto, Linda
AU - Prezant, David J.
N1 - Funding Information:
This work was supported by the National Institute for Occupational Safety and Health.
Funding Information:
Funding for this work was provided by the National Institute for Occupational Safety and Health (NIOSH) RO1-OH07350. NIOSH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
PY - 2010/3
Y1 - 2010/3
N2 - Background: We evaluated the performance of a modified Center of Epidemiologic Studies Depression Scale (CES-D-m), which captured symptoms in the past month, in comparison to the Diagnostic Interview Schedule (DIS) in identification of major depressive disorder (MDD) in World Trade Center (WTC)-exposed retired Fire Department, City of New York (FDNY) firefighters. Methods: From 12/2005 to 7/2007, FDNY enrolled retired firefighters in its Medical Monitoring and Treatment Program. All participants completed the CES-D-m and the DIS on the same day. Sensitivity, specificity, receiver operating characteristic (ROC) curves, and Youden's index were used to assess properties of the CES-D-m. Multivariate logistic regression analyses were also used. Results: 7% of 1915 retired male firefighters were diagnosed with MDD using the DIS. Using the most common CES-D cutoff score of 16, the prevalence of elevated risk was 36%, which declined to 23% using a cutoff score of 22, as determined by Youden's index. At 22, CES-D-m sensitivity was 0.84, specificity was 0.82, and the area under the ROC curve was 0.89 relative to DIS MDD diagnosis. Limitations: Participants were more likely than non-participants to live in the New York City area. Conclusions: This is the first study of WTC rescue/recovery workers to assess the performance of a one-month version of the CES-D. The CES-D-m performed well in identifying those at elevated risk. Since diagnostic follow-up is time consuming and costly, it is important to correctly distinguish those at elevated risk using a screening tool that has been validated in the population under study.
AB - Background: We evaluated the performance of a modified Center of Epidemiologic Studies Depression Scale (CES-D-m), which captured symptoms in the past month, in comparison to the Diagnostic Interview Schedule (DIS) in identification of major depressive disorder (MDD) in World Trade Center (WTC)-exposed retired Fire Department, City of New York (FDNY) firefighters. Methods: From 12/2005 to 7/2007, FDNY enrolled retired firefighters in its Medical Monitoring and Treatment Program. All participants completed the CES-D-m and the DIS on the same day. Sensitivity, specificity, receiver operating characteristic (ROC) curves, and Youden's index were used to assess properties of the CES-D-m. Multivariate logistic regression analyses were also used. Results: 7% of 1915 retired male firefighters were diagnosed with MDD using the DIS. Using the most common CES-D cutoff score of 16, the prevalence of elevated risk was 36%, which declined to 23% using a cutoff score of 22, as determined by Youden's index. At 22, CES-D-m sensitivity was 0.84, specificity was 0.82, and the area under the ROC curve was 0.89 relative to DIS MDD diagnosis. Limitations: Participants were more likely than non-participants to live in the New York City area. Conclusions: This is the first study of WTC rescue/recovery workers to assess the performance of a one-month version of the CES-D. The CES-D-m performed well in identifying those at elevated risk. Since diagnostic follow-up is time consuming and costly, it is important to correctly distinguish those at elevated risk using a screening tool that has been validated in the population under study.
KW - Center for Epidemiologic Studies Depression Scale
KW - Depression
KW - Firefighter
KW - Validation
KW - World Trade Center
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U2 - 10.1016/j.jad.2009.05.028
DO - 10.1016/j.jad.2009.05.028
M3 - Article
C2 - 19539999
AN - SCOPUS:74449091804
SN - 0165-0327
VL - 121
SP - 212
EP - 219
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 3
ER -