Using the CES-D-7 as a Screening Instrument to Detect Major Depression among the Inmate Population

Int J Environ Res Public Health. 2021 Feb 2;18(3):1361. doi: 10.3390/ijerph18031361.


Major depression is one of the most prevalent mental health problems in the penitentiary context and has been related to different undesirable outcomes. The aim of the current research was to evaluate the utility of screening tools for major depression brief assessment in the jail context. We interviewed 203 male inmates and complimented the MCMI-III, the SCL-90-R, and the CES-D-7 self-informed scales. Major depression syndrome and disorder were determined based on MCMI-III criteria and the capability of SCL-90-R and CES-D-7 to identify true positives and true negatives when tested. SCL-90-R and CES-D-7 showed good sensitivity for major depression syndrome and disorder. The specificity of SCL-90-R was poor in all cases, but CES-D-7 showed good specificity depending on the cut-off score. Rigorous interviews are needed for better evaluation of major depression in jails, but screening tools like CES-D-7 are useful for rapid assessment considering the work overload of penitentiary psychologists.

Keywords: CES-D-7; major depression; mental health services; prisons; screening instruments.

MeSH terms

  • Depression
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / epidemiology
  • Humans
  • Male
  • Mass Screening
  • Psychiatric Status Rating Scales
  • Reproducibility of Results
  • Sensitivity and Specificity