20-item screening test for depressive symptoms in the general population. ≈ 5 min to complete. Free with attribution.
CES-D (Center for Epidemiologic Studies Depression Scale) is a validated clinical instrument used to assess 20-item screening test for depressive symptoms in the general population.. It is most often used for 20-item screening test for depressive symptoms in the general population.. The instrument contains 20 items. Typical administration time is ≈ 5 min.
Source / attribution: Free to use with citation
20-item screening test for depressive symptoms in the general population. CES-D is part of standard practice in this setting because it provides a structured, replicable assessment that can be tracked over time and compared across patients or visits.
Like all screening or assessment instruments, CES-D is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 20 items below to see your CES-D score and interpretation.
Each item is scored on a 4-point scale (0–3). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
Sum all 20 items scored 0-3. Total range 0-60. Score >= 16 suggests clinically significant depression.
Scoring notes: Sum all 20 items scored 0-3. Total range 0-60. Score >= 16 suggests clinically significant depression.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–15 | Not depressed | None |
| 16–21 | Mild depression | Monitor |
| 22–35 | Major depression | Consider treatment |
| 36–60 | Severe depression | Immediate treatment |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | I was bothered by things that usually don't bother me | Some or a little of the time | 1 |
| 2 | I did not feel like eating; my appetite was poor | Some or a little of the time | 1 |
| 3 | I felt that I could not shake off the blues even with help from my family or friends | Some or a little of the time | 1 |
| 4 | I felt that I was just as good as other people | Occasionally or moderate | 1 |
| 5 | I had trouble keeping my mind on what I was doing | Some or a little of the time | 1 |
| 6 | I felt depressed | Some or a little of the time | 1 |
| 7 | I felt that everything I did was an effort | Some or a little of the time | 1 |
| 8 | I felt hopeful about the future | Occasionally or moderate | 1 |
| 9 | I thought my life had been a failure | Some or a little of the time | 1 |
| 10 | I felt fearful | Some or a little of the time | 1 |
| 11 | My sleep was restless | Some or a little of the time | 1 |
| 12 | I was happy | Occasionally or moderate | 1 |
| 13 | I talked less than usual | Some or a little of the time | 1 |
| 14 | I felt lonely | Some or a little of the time | 1 |
| 15 | People were unfriendly | Some or a little of the time | 1 |
| 16 | I enjoyed life | Occasionally or moderate | 1 |
| 17 | I had crying spells | Some or a little of the time | 1 |
| 18 | I felt sad | Some or a little of the time | 1 |
| 19 | I felt that people dislike me | Rarely or none of the time | 0 |
| 20 | I could not get going | Some or a little of the time | 1 |
Add up all the item scores you noted in Step 1.
1 + 1 + 1 + 1 + 1 + 1 + 1 + 1 + … (items 9–20 sum to 11) = 19
Find the row in the interpretation table whose range contains your total:
Total = 19 falls between 16 and 21 → Mild depression
Mild depression. Monitor
A score is one input alongside history and examination. CES-D supports clinical judgment — it does not replace it.
Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.
If CES-D doesn't fit your context, related instruments in depression include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| PHQ-2 | Ultra-brief depression screening for busy clinical settings. | 2 | ≈ 1 min |
| PHQ-8 | Research version of PHQ-9 excluding suicidality item for general population studies. | 8 | ≈ 2 min |
| HADS-D | 7-item depression subscale designed for hospital and clinical outpatient settings. | 7 | ≈ 2 min |
| SDS | 20-item self-report scale measuring affective, psychological, and somatic symptoms of depression. | 20 | ≈ 5 min |
| PHQ-9 | Severity of depression | 9 | ≈ 3 minutes |
| GAD-7 | Severity of generalized anxiety | 7 | ≈ 2 minutes |
| AUDIT | 10-item WHO screening tool for hazardous alcohol consumption and dependence. | 10 | ≈ 3 min |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
CES-D (Center for Epidemiologic Studies Depression Scale) is a validated instrument that assesses depressive symptoms in the general population. It is designed for clinicians, medical students, evidence-synthesis researchers. It takes about 5 min to complete, and the 20 items are summed to produce a total score.
CES-D typically takes about 5 min to administer. The exact duration varies a little depending on whether it is self-administered or completed with a clinician. Its brief format is part of what makes it practical for routine clinical use and for repeat administration when tracking change over time.
CES-D contains 20 items. Item scores are summed to produce the total. Scores run from 0 to 60, grouped into 4 interpretation bands from ‘Not depressed’ up to ‘Severe depression’.
On the CES-D (total score 0–60), scores of 36–60 fall in the ‘Severe depression’ band — interpreted as: Immediate treatment. The full ladder is: 0–15 — Not depressed: None.; 16–21 — Mild depression: Monitor.; 22–35 — Major depression: Consider treatment.; 36–60 — Severe depression: Immediate treatment. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–15 fall in the ‘Not depressed’ band: None. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
CES-D has reported Cronbach's α of 0.85 in validation samples and test–retest reliability of 0.7. Good sensitivity and specificity for major depression in community samples. In practical terms, a Cronbach’s α around 0.85 indicates good internal consistency (the items hang together well), and a test–retest reliability of 0.7 means scores are well when the scale is repeated without real clinical change.
CES-D is free to use with attribution — clinical, educational, and research use is permitted provided the original source is credited. If you publish results or reproduce the scale, include the citation to the source paper.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401. This is the original publication for the CES-D — the reference to cite when reporting results.
No. CES-D is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of depressive symptoms in the general population — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
CES-D is supported by the following peer-reviewed sources: