Psychometric properties and validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a population attending an HIV clinic in Cali-Colombia

Introduction: Depression in people living with HIV/AIDS is associated with poor health outcomes. Yet, assessment of depressive symptoms is not a routine clinical practice in the care of people with HIV in Colombia. This might be due to the lack of validated depression screening scales for this population. Objective: To test the reliability and construct validity of the 20 and 10 item -Center for Epidemiological Studies Depression Scale in patients attending a clinic in Cali, Colombia. Materials and methods: A non-random sample of 105 adults was enrolled. The 20 item CES-D scale was administered twice: (baseline and 2-4 weeks later). The Cronbach's coefficient a, the intraclass Correlation Coefficient were calculated. And use exploratory, confirmatory factorial analysis, and item response theory to assess validity of the scale. Results: Most participants were men (73%), with a mean age of 40 years, 53% of whom had not completed high school. Cronbach's were 0.92, and 0.94, at baseline and at the second interview, respectively. The intra-class correlation was 0.81 (CI 95%: 0.72-0.88). Although all 20 items loaded distinctly in 4 factors, 5 items did not load as expected. The factors structure of the 20-items CES-D was not confirmed, with 4 items having bad goodness of fit. The 10-CES-D, seems to work better in this population. Conclusions: These results support the reliability and validity of the 10-CES-D instrument to screen for depressive symptoms in people with HIV in Colombia.