ArticleJournal of clinical epidemiology2025
Cross-national statistical harmonization of the Center for Epidemiologic Studies Depression (CES-D) scale among older adults in China, England, India, Mexico, South Africa, and the United States.
Article in Journal of clinical epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Incremental Information from Repeated Loneliness Assessments in Middle-Aged and Older Adults.Healthcare (Basel, Switzerland) · 2026Article
- The Thought Induction Psychotherapy Technique's Clinical Effectiveness in Treating Adolescent Depression and Anxiety: A Randomized Controlled Trial.Psychiatry investigation · 2026Article
- Association and mediating pathways between intergenerational educational mobility and depressive symptoms: findings from high- and middle-income countries.BMC medicine · 2026Article
- Academic burnout and internet gaming disorder in Chinese adolescents: The chain mediating roles of depressive symptoms and negative attentional bias.Pediatric investigation · 2026Article
- Development of a machine learning-based screening model for the risk of depression among the elderly in China.BMC geriatrics · 2026Article
- Differences in protective resources and risks for depressive symptoms among recent widows in the United States and India.American journal of epidemiology · 2026Article
- Revisiting the factor structure of the EURO-D, a depressive symptomatology scale: An exploratory graph analysis in 26 European countries.Global mental health (Cambridge, England) · 2026Article
- Cross-sectional associations of metabolic risk indices and cardiometabolic multimorbidity among adults with depressive symptoms: evidence from China and the United Kingdom.Archives of medical science : AMS · 2026Article
- The Mediating Role of Depression in the Effect of Psychological Well-Being on the Self-Rated Health and Quality of Life of Older Adults: Cross-Sectional Study.Interactive journal of medical research · 2025Article
- Cumulative loneliness and memory function among U.S. older adults: the role of depressive symptoms.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- A significant atypical U-shaped relationship exists between Lipid Accumulation Product and depression prevalence among Chinese middle-aged and elderly men: a cross-sectional study based on CHARLS.Frontiers in nutrition · 2025Article
- Associations between physical activity and prenatal depression and anxiety symptoms: a cross-sectional study.Frontiers in public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectivesWe examined differential item functioning (DIF) of the Center for Epidemiologic Studies Depression Scale (CES-D) items by country and statistically harmonized common cross-national factor scores for the CES-D to aid further cross-national research. STUDY DESIGN AND
settingData were from Harmonized Cognitive Assessment Protocol (HCAP) studies in China (N = 9639), England (N = 1262), India (N = 4048), Mexico (N = 1918), South Africa (N = 631), and the United States (N = 3321). Multiple indicators, multiple causes models were estimated to test DIF in the CES-D items by country. DIF items were defined as having an odds ratio (OR) outside the range of 0.75-1.25 in multiple indicators, multiple causes models. We evaluated DIF impact and identified salient DIF by examining whether the difference between DIF-adjusted factor scores and non-DIF-adjusted factor scores exceeded a threshold of 0.30 standard deviation (SD) units. Confirmatory factor analysis was used to create DIF-adjusted, cross-nationally harmonized CES-D factor scores.
resultsControlling for underlying depressive symptoms, HCAP participants in India had higher odds of reporting being not hopeful about future (OR = 1.38, 95% confidence interval [CI]: 1.34-1.42), not enjoying life (OR = 1.43, 95% CI: 1.38-1.48), and being unhappy (OR = 1.29, 95% CI: 1.25-1.34), compared to HCAP participants in the United States. These identified DIF items artificially increased mean harmonized CES-D factor scores by 0.48 SD units in the India HCAP, with over 50% of the factor scores increased by over 0.30 SD units, indicating salient DIF in the India HCAP.
conclusionOur findings demonstrate cross-national heterogeneity in the expression of depressive symptoms. We provide DIF-adjusted CES-D factor scores to improve the quality of cross-national comparisons in aging research.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.