Using the CES-D scale to screen for depression and anxiety: effects of language and ethnic status

The purpose of this report is to present data on the effects of language (English/Spanish) and ethnic status (white/non-Hispanic or Mexican origin) on the ability of the Center for Epidemiologic Studies Depression (CES-D) scale to detect cases of clinical depression and generalized anxiety identified using the Diagnostic Interview Schedule (DIS) in psychiatric treatment settings. The agreement between the CES-D scale and the DIS diagnoses of major depressive disorder (MDD) and generalized anxiety disorder (GAD) was poor, especially among Mexican-origin patients interviewed in Spanish. Multiple regression analysis revealed that the CES-D scale was positively associated with MDD in all groups. In addition, GAD also was associated with the CES-D scale in Anglos and English-speaking Mexican-Americans but not in Spanish-speaking Mexican-Americans.