The factor structure of the center for epidemiologic studies depression scale in stroke patients

The purpose of this study is to investigate the factor structure of the Center for Epidemiologic Studies Depression (CES-D) scale in community-residing stroke patients.

The sample for this study was a convenience sample of 203 persons who had experienced strokes and were in a convalescent center for the disabled and a primary care unit in Korea. Data were collected through a questionnaire that included the CES-D scale. Cognitive function was assessed by the validated Korean version of the Mini-Mental State Examination (MMSE-K). The structure of the CES-D scale was analyzed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) using SPSS 17.0 and Amos 7.0. The reliability of the CES-D scale was assessed by calculating the internal consistency of Cronbach's α.

The 1-, 3-, and 4-factor models did not show the adequate fit indices. Two competing factor models were tested by CFA for the entire sample after identifying the factor structure using EFA. The 5-factor structure (loss of vitality, positive affect, psychomotor retardation, negative affect, and interpersonal problems) supported and explained 61.25% of the variance.

The results of this study suggest that the CES-D scale is a useful depressive symptom screening tool for community-residing stroke patients. Identifying the psychometric properties of the CES-D scale would help health professionals to understand the comprehensive assessment of community-residing stroke patients.