Usefulness of a single-item measure of depression to predict mortality: the GAZEL prospective cohort study

Eur J Public Health. 2012 Oct;22(5):643-7. doi: 10.1093/eurpub/ckr103. Epub 2011 Aug 11.


Background: It remains unknown whether short measures of depression perform as well as long measures in predicting adverse outcomes such as mortality. The present study aims to examine the predictive value of a single-item measure of depression for mortality.

Methods: A total of 14,185 participants of the GAZEL cohort completed the 20-item Center-for-Epidemiologic-Studies-Depression (CES-D) scale in 1996. One of these items (I felt depressed) was used as a single-item measure of depression. All-cause mortality data were available until 30 September 2009, a mean follow-up period of 12.7 years with a total of 650 deaths.

Results: In Cox regression model adjusted for baseline socio-demographic characteristics, a one-unit increase in the single-item score (range 0-3) was associated with a 25% higher risk of all-cause mortality (95% CI: 13-37%, P<0.001). Further adjustment for health-related behaviours and physical chronic diseases reduced this risk by 36% and 8%, respectively. After adjustment for all these variables, every one-unit increase in the single-item score predicted a 15% increased risk of death (95% CI: 5-27%, P<0.01). There is also an evidence of a dose-reponse relationship between reponse scores on the single-item measure of depression and mortality.

Conclusion: This study shows that a single-item measure of depression is associated with an increased risk of death. Given its simplicity and ease of administration, a very simple single-item measure of depression might be useful for identifying middle-aged adults at risk for elevated depressive symptoms in large epidemiological studies and clinical settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death*
  • Depression / complications
  • Depression / diagnosis*
  • Depression / mortality*
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires