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Validating the Center for Epidemiological Studies Depression Scale for Children in Rwanda
Theresa Betancourt1, Pamela Scorza, Sarah Meyers-Ohki
1Research Program on Children and Global Adversity, François-Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard School of Public Health, 651 Huntington Avenue, Boston, MA 02115, USA. Theresa_Betancourt@harvard.edu
The Center for Epidemiological Studies Depression Scale for Children (CES-DC) is a valid tool for screening depression in Rwandan youth. This scale shows good reliability and accuracy in identifying depression in low-resource settings.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Screening
- Psychometrics
Background:
- The Center for Epidemiological Studies Depression Scale for Children (CES-DC) is widely used in high-income countries.
- Its validity in low-income, culturally diverse settings like sub-Saharan Africa remains unestablished.
Purpose of the Study:
- To assess the validity of the CES-DC for screening depression in Rwandan children and adolescents.
- To evaluate the scale's psychometric properties in a low-resource context.
Main Methods:
- The CES-DC was administered to 367 Rwandan children and adolescents (ages 10-17).
- Criterion validity was examined by comparing CES-DC scores with diagnoses from the Mini International Neuropsychiatric Interview for Children (MINI KID).
- Local expressions of depression, 'agahinda kenshi' (persistent sorrow) and 'kwiheba' (severe hopelessness), were also assessed.
Main Results:
- The CES-DC demonstrated good internal reliability (α = .86) and test-retest reliability (r = .85).
- The area under the ROC curve was 0.825, indicating strong diagnostic ability.
- A cut point of ≥30 yielded 81.9% sensitivity and 71.9% specificity in the referred sample.
Conclusions:
- The CES-DC exhibits favorable psychometric properties for depression screening in Rwanda.
- The scale is recommended for use in Rwanda and similar low-resource settings.
- Further research with general population samples is needed to establish a generalizable cut point.
