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Uwagi do wersji zaadaptowanej:

Wersja elektroniczna książki została stworzona zgodnie z art. 33 z indeksem 1 Ustawy o prawie autorskim i prawach pokrewnych.

Zostały zachowane numery stron. Numer danej strony znajduje się nad tekstem danej strony i poprzedza go skrót P.

Wartości wyrażone w oryginale liczbami rzymskimi, w adaptacji przedstawiono cyframi arabskimi.

Przypisy w treści głównej są linkami oznaczonymi słowem „footnote” lub „footnote.” i numerem porządkowym wziętymi w nawias kwadratowy. Linki te prowadzą do opisów przypisów, które zostały umieszczone na końcu dokumentu. Powrót do treści głównej po odczytaniu opisu przypisu jest możliwy poprzez link „Return to the main document”

umieszczony na końcu każdego opisu przypisu.

Zakładki oznaczone literą „f.” lub „f” i numerem porządkowym znajdują się w treści głównej, w miejscu występowania przypisu.

Wykaz skrótów:

et al. - et alii i.e. - id est ed. - edition

DOI - digital object identifier

CESD-R - The Center for Epidemiologic Studies Depression Scale-Revised CES-D - The Centre for Epidemiological Studies Depression Scale

US - United States

WHO - World Health Organization BDI - Beck Depression Inventory

DSM - Diagnostic and statistical manual of mental disorders

ICD-10 - International Statistical Classification of Diseases and Related Health Problems MMPI - Minnesota Multiphasic Personality Inventory

PTP - Pracownia Testów Psychologicznych Psychiatr. Pol. - Psychiatria Polska

Psychiatr. Prakt. Ogólnolek. - Psychiatria w Praktyce Ogólnolekarskiej Arch. Gen. Psychiatry - Archives Of General Psychiatry

J. Neurol. Neurosurg. Psychiatry - Journal of Neurology, Neurosurgery, and Psychiatry Am. J. Psychiatry - The American Journal of Psychiatry

Br. J. Psychiatry - British Journal of Psychiatry

Appl. Psychol. Meas. - Applied Psychological Measurement

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Psychiatry Res. - Psychiatry Research M - mean

SD - standard deviation Min. - minimum

Max. - maximum

Koniec uwag do wersji zaadaptowanej.

P. 1109

Psychiatr. Pol. 2016; 50(6): 1109-1117 PL ISSN 0033-2674 (PRINT),

ISSN 2391-5854 (ONLINE) www.psychiatriapolska.pl DOI: https://doi.org/10.12740/PP/61614

Assessment of depressiveness in population. Psychometric evaluation of the Polish version of the CESD-R

Karolina Koziara

Institute of Psychology, Jagiellonian University

Summary

Aim. Psychometric evaluation of reliability and usefulness of the Polish version of the CESD-R - a revised version of the CES-D - screening test for depression.

Methods. In an online survey the CESD-R and the Beck Depression Inventory were applied to 260 participants (men and women). Reliability was assessed with Cronbach's method and split-half (odd-even) method. Same as in the original English publication, factor analysis was performed and three factors were distinguished. Additionally, the CESD-R results were compared with the Beck Depression Inventory results.

Results. Analysis of the CESD-R resulted in high values of reliability, for Cronbach's alpha coefficient the result was 0.95, for split-half (odd-even) method based on Spearman-Brown formula α equal 0.95. Factor analysis distinguished 3 principal factors such as cognitive- affective factors, physical factors, and self-destructive factors.

Conclusions. Polish version of the CESD-R appears to have reliability values (over 0.7) high enough to be applicable to assess depression in population-based samples.

Usefulness of the CESD-R in an individual diagnosis needs further research. However,

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general analysis of the scale enables to expect the usefulness in at least introductory diagnosis in clinical practice.

Key words: depression, CESD-R, factor analysis The study was not sponsored.

Introduction

Depression is considered to be one of the most common mental disorders. It is estimated that every year 5 percent of US population suffer from major depression episode [footnote 1]. According to Polish studies over 20 percent of physicians' patients experience some kind of depressive symptoms [footnote 2 ].

P. 1110

Depressive symptoms affect everyone, regardless of place of birth, place of residence or occupation. According to WHO about 350 million people all over the world suffer from depression, [footnote 3 ]. Affective disorders, regardless of intensity, cause impairment of social and occupational functioning; that is why it is urgent to upgrade research tools to make the diagnosis of depressive symptoms easier and more effective and consequently to prevent the development of severe depression.

In Poland, most popular research tool used to assess prevalence of depression in general population as well as in clinical samples is the Beck Depression Inventory (BDI) [footnote 4], adapted and translated among others by Parnowski and Jernajczyk [footnote 5 ].

Despite its popularity, the BDI is widely criticized for being outdated with respect to DSM [footnote 6 ] and ICD [footnote 7 ]. The Hamilton Depression Rating Scale is also used in research [footnote 8 ], however, it is criticized for weak content validity, inadequate items, or inadequate answers which are not compatible with every question. According to Bagby et al. [footnote 9 ], all defects mentioned above result in multidimensional and unclear final rate of the Hamilton Depression Rating Scale, which makes the interpretation difficult.

Williams et al. [footnote 10 ] compared nine scales designed to assess depressiveness, i.e.

the Center for Epidemiologic Studies Depression Scale - Revised (CESD-R), the Beck Depression Inventory, the Hamilton Depression Rating Scale (17-item version), and the Montgomery-Åsberg Depression Scale [footnote 8, 11, 12 ]. They concluded that every scale gained satisfying psychometric evaluation, However, it is worth mention that the CESD-R took less than 3 minutes to complete it, additional advantage is that it is a self- reporting scale (unlike the Montgomery-Åsberg Depression Scale, filled by the clinician); it

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also contains short and understandable items [footnote 10 ]. It is worth mentioning that the Minnesota Multiphasic Personality Inventory (MMPI-2) is also used within clinical sample - depressiveness is assessed on one of the subscales. Although, reliability of the MMPI-2 is satisfying, the length (567 items) is disheartening; also it may be properly interpreted only by a professional and experienced psychologist [footnote 13 ].

Concerned about uselessness of popular research tools for assessing depressiveness, L.S. Radloff created the tool useful for the study of depression in general population. The CES-D (the Center for Epidemiologic Studies Depression Scale) aimed to assess

prevalence of affective symptoms, especially depressive mood. The fact that this tool is also directed to people whose symptoms in differential diagnosis will not qualify them to the group with clinical features is considered as an advantage [footnote 14 ].

The aim of Radloff's CES-D [footnote 14 ] was to assess prevalence of depression in general population, contradictory to scales existing at that time developed for and used in clinical diagnosis. The CES-D, as well acclaimed scale, has been translated to other languages and is also applicable to adolescents [footnote 15 ]. Approximately thirty years after the CES-D publication, W. Eaton with his team updated the original scale to actual, of that time, DSM-4-TR criteria [footnote 16 ]. They developed the CESD-R which included 20 item concerning behavior and mood occurring within last two weeks [footnote 11 ].

Comparing to the original CES-D (one-week), the two-week period (CESD-R) of symptoms occurring was innovative and compatible with DSM-4-TR criteria. The advantage of both scales is a possibility of assessment the level of depressive symptoms without

dichotomous division into normal and pathological ones.

P. 1111

As an advantage of using the CESD-R we may consider the time needed to complete it (about 3-4 minutes), it is especially important while doing population-based research using a lot of research tools. Additionally, items of the CESD-R are clear and understandable for people of various age and education level.

Material

1. Beck Depression Inventory - self-report scale designed by A. Beck [footnote 4 ] to measure the level of depression. The Polish adaptation of the scale, made by Parnowski and Jernajczyk, has been used in this study [footnote 5 ].

2. CESD-R - self-report scale to measure the level of depression, originally presented by Eaton et al. [footnote 11 ]. Translation and adaptation method is described below.

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Method

Application of the CESD-R

The CESD-R [footnote 11 ] is a self-report 20-item scale. In reference to every item, describing mood or behavior, individuals choose one of five possible answers concerning its frequency. Answers from 0 (not at all or less than 1 day) to 4 (nearly every day for two weeks) need to be added. The sum of these results evaluates the level of depressive symptoms. The lowest score possible on the CESD-R scale is 0, and the highest is 80 points. The authors of the original tool suggested that the result of 16 points or higher, can be considered as alarming and in case of obtaining such a result one should consider visiting a professional counselor (psychologist or psychiatrist), however, further research are not conclusive and do not support that suggestion as a right one [footnote 17 ].

CESD-R translation procedure

The CESD-R was translated to Polish with author's - W.W. Eaton (2014) - permission. At first, the scale was translated from English by 4 independent people (2 men, 2 women), differed by age and education. Next, another 4 people (2 men, 2 women) also differed by age and education, did the back-translation from Polish to English. Back-translations were almost identical as the original version of the scale, in both instruction and items. English philologist was asked for assessment of all versions (original scale, Polish translation and back-translation). After the final assessment of the Polish translation and language

correction, the unified Polish version of the scale was presented to 10 independent people (4 men and 6 women, 19-36 years of age, 8 of them completed tertiary education, 2 had secondary education, none of them was a psychologist) asked to assess understandability of items and instructions. On the basis of their review the final form of the Polish version of the CESD-R was approved.

P. 1112 Participants

260 people, including 175 women and 85 men, participated in an online survey. 63 people, including 50 women and 13 men, admitted getting professional help from psychologist or psychiatrist due to affective disorders. Mean age of participants was 23.5 years (SD equal 5.92), the youngest person was 16 and the oldest one was 54 years old.

221 people (146 women, 75 men) identified themselves as heterosexual (85 percent), 19 as homosexual (13 women, 6 men), 18 as bisexual (14 women, 4 men). 2 women

described their identity as „other”.

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The majority of participants live in cities with population exceeding 500,000 inhabitants (42.3 percent), 21 percent live in cities with population between 100,000 and 500,000 inhabitants, 5.8 percent live in towns with 50,000 - 100,000 inhabitants, and 31.2 percent live in towns with population under 50,000 inhabitants.

Results

The maximum possible the CESD-R score is 80, the minimum - 0. Mean result within the research group was 22.12, SD equal 17.60, minimum score was 0, maximum was 76.

Table 1 contains mean results for men and women, and the group in general. Men generally scored higher on the CESD-R (23 points), comparing to women (22 points).

Both, women and men, who were not receiving professional help from counselor

(psychologist or/and psychiatrist) obtained about 19 points (19.24 and 19.90 respectively).

Men receiving professional help (psychologist/psychiatrist) obtained 40.77 points, while women obtained 27.68 points on average.

Table 1. Mean values of the CESD-R scale for each group. M - mean; SD - standard deviation. Skip Table 1.

1.1. Total (n equal 260):

1.2. CESD-R results, M: 22.12 1.3. CESD-R results, SD: 17.60 1.4. CESD-R results, Min.: 0 1.5. CESD-R results, Max.: 76 2.1. Women (n equal 175):

2.2. CESD-R results, M: 21.65 2.3. CESD-R results, SD: 17.56 2.4. CESD-R results, Min.: 0 2.5. CESD-R results, Max.: 76

3.1. Women not treated [footnote 1] (n equal 125) 3.2. CESD-R results, M: 19.24

3.3. CESD-R results, SD: 16.16 3.4. CESD-R results, Min.: 0 3.5. CESD-R results, Max.: 65

4.1. Women treated [footnote 2] (n equal 50) 4.2. CESD-R results, M: 27.68

4.3. CESD-R results, SD: 19.56

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4.4. CESD-R results, Min.: 0 4.5. CESD-R results, Max.: 76 5.1. Men (n equal 85)

5.2. CESD-R results, M: 23.09 5.3. CESD-R results, SD: 17.74 5.4. CESD-R results, Min.: 0 5.5. CESD-R results, Max.: 71

6.1. Men not treated [footnote 3] (n equal 72) 6.2. CESD-R results, M: 19.9

6.3. CESD-R results, SD: 15.8 6.4. CESD-R results, Min.: 0 6.5. CESD-R results, Max.: 71

7.1. Men treated [footnote 4] (n equal 13) 7.2. CESD-R results, M: 40.77

7.3. CESD-R results, SD: 18.02 7.4. CESD-R results, Min.: 13 7.5. CESD-R results, Max.: 65 End Table 1.

P. 1113

CESD-R validation

For comparison, the Beck Depression Inventory [footnote 4, 5 ] has been also presented to participants. Cronbach's alpha for the BDI was 0.89.

Reliability analysis for the CESD-R was assessed using Cronbach's alpha and split-test method. Cronbach's alpha for the CESD-R was 0.95, split-half (even-odd, with Spearman- Brown formula) was 0.95.

Correlation of the CESD-R and the Beck Depression Inventory was r equal 0.73, p <

0.0001.

Factor analysis enabled to identify 3 groups of factors. Tables 2 and 3 present total variance explained and principal factors. Total variance explained is satisfying [footnote 18]. Groups of factors identified in the analysis may be described as cognitive-affective (factor 1), physical (factor 2) and self-destructive (factor 3). It is worth to mention that the authors of the original scale also identified 3 factors, however, they suggest interpreting the final score as a whole, without division into separate factors [footnote 11 ].

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Table 2. Factor analysis - explained variance. Skip Table 2.

1.1. Factor 1: Explained variance 1.2. Percent of variance: 51.51 1.3. Cumulative percent: 51.51 2.1. Factor 2: Explained variance 2.2. Percent of variance: 7.53 2.3. Cumulative percent: 59.04 3.1. Factor 3: Explained variance 3.2. Percent of variance: 5.80 3.3. Cumulative percent: 64.83 End of Table 2.

Table 3. CESD-R components. Principal components (rotation: Oblimin with Kaiser normalization); rejected values < 0.3. Skip Table 3.

1.1. Item CESD-R: 4. I felt depressed. (Czułem(am) się przygnębiony(a)).

1.2. Factor 1: 0.903 1.3. Factor 2: lack 1.4. Factor 3: lack

2.1. Item CESD-R: 6. I felt sad. (Czułem(am) się smutny(a)).

2.2. Factor 1: 0.900 2.3. Factor 2: lack 2.4. Factor 3: lack

3.1. Item CESD-R: 2. I could not shake off the blues. (Nie mogłem(am) pozbyć się chandry).

3.2. Factor 1: 0.877 3.3. Factor 2: lack 3.4. Factor 3: lack

4.1. Item CESD-R: 3. 3. I had trouble keeping my mind on what I was doing. (Miałem(am) problem ze skupieniem się na tym co robię?).

4.2. Factor 1: 0.867 4.3. Factor 2: lack 4.4. Factor 3: lack

5.1. Item CESD-R: 7. I could not get going. (Nie mogłem(am) zebrać się do działania.) 5.2. Factor 1: 0.844

5.3. Factor 2: lack

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5.4. Factor 3: lack

6.1. Item CESD-R: 20. I could not focus on the important things. (Nie mogłem(am) skupić się na ważnych rzeczach.)

6.2. Factor 1: 0.784 6.3. Factor 2: lack 6.4. Factor 3: lack

7.1. Item CESD-R: 13. I felt fidgety. (Czułem(am) się niespokojny(a).) 7.2. Factor 1: 0.775

7.3. Factor 2: lack 7.4. Factor 3: lack

8.1. Item CESD-R: 8. Nothing made me happy. (Nic mnie nie cieszyło.) 8.2. Factor 1: 0.758

8.3. Factor 2: lack 8.4. Factor 3: lack

9.1. Item CESD-R: 16. I was tired all the time. (Cały czas byłem(am) zmęczony.) 9.2. Factor 1: 0.667

9.3. Factor 2: lack 9.4. Factor 3: lack

10.1. Item CESD-R: 10. I lost interest in my usual activities. (Straciłem(am) zainteresowanie codziennymi zajęciami.)

10.2. Factor 1: 0.634 10.3. Factor 2: lack 10.4. Factor 3: lack

11.1. Item CESD-R: 9. I felt like a bad person. (Czułem(am) się złym człowiekiem.) 11.2. Factor 1: 0.552

11.3. Factor 2: lack

11.4. Factor 3: minus 0.313 table continued on the next page

P. 1114

12.1. Item CESD-R: 12. I felt like I was moving too slowly. (Czułem(am) jakbym poruszał się zbyt wolno.)

12.2. Factor 1: 0.541 12.3. Factor 2: lack 12.4. Factor 3: lack

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13.1. Item CESD-R: 17. I did not like myself. (Nie lubiłem(am) siebie.) 13.2. Factor 1: 0.496

13.3. Factor 2: lack

13.4. Factor 3: minus 0.406

14.1. Item CESD-R: 5. My sleep was restless. (Mój sen był niespokojny.).

14.2. Factor 1: 0.485 14.3. Factor 2: lack 14.4. Factor 3: lack

15.1. Item CESD-R: 18. I lost a lot of weight without trying to. (Mimowolnie straciłem(am) dużo na wadze.)

15.2. Factor 1: lack 15.3. Factor 2: 0.856 15.4. Factor 3: lack

16.1. Item CESD-R: 1. My appetite was poor. (Miałem(am) kiepski apetyt).

16.2. Factor 1: lack 16.3. Factor 2: 0.770 16.4. Factor 3: lack

17.1. Item CESD-R: 19. I had a lot of trouble getting to sleep. (Miałem(am) problemy z zaśnięciem.)

17.2. Factor 1: lack 17.3. Factor 2: 0.553 17.4. Factor 3: lack

18.1. Item CESD-R: 15. I wanted to hurt myself. (Chciałem(am) zrobić sobie krzywdę.) 18.2. Factor 1: lack

18.3. Factor 2: lack

18.4. Factor 3: minus 0.756

19.1. Item CESD-R: 14. I wished I were dead. (Chciałem(am) umrzeć.) 19.2. Factor 1: lack

19.3. Factor 2: lack

19.4. Factor 3: minus 0.736

20.1. Item CESD-R: 11. I slept much more than usual. (Spałem(am) o wiele dłużej niż zazwyczaj.)

20.2. Factor 1: 0.42 20.3. Factor 2: 0.366 20.4. Factor 3: 0.429

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End of Table 3.

Discussion

The aim of the study was psychometric evaluation of the Polish adaptation of the CESD-R, the scale designed to measure depressiveness in general population. Reliability checked with split-half method and Cronbach's alpha method, shows values high enough (< 0.7) to validate the scale [footnote 18 ]. Factor analysis allowed us to identify three principal factors, which may be described as cognitive-affective, physical and self-destructive.

The CESD-R is worth using in population-based research because of short time needed to complete it (about 3 minutes), and clear and understandable items, accessible for people of various age and education. Easy and short the CESD-R is especially useful in research using a lot of tools, were it is important how tiring and time-taking the tools are for

participants.

The general disadvantage of the CESD-R, especially in clinical context, may be lack of clear cut-off point enabling differentiation between healthy individuals and the ones with depression. The authors suggested the result of 16 points or higher as a result high enough to visit a professional counselor. Further research using the CESD-R are not conclusive as to the result of 16 points differentiate between clinical and nonclinical samples [footnote 17 ]. However, it must be underlined that the CES-D (as well as the CESD-R) was designed to assess depressive symptoms in population-based samples, not in clinical ones, and as that kind of tool is worth using within the research.

Conclusions

The Polish version of the CESD-R, as reliable scale that correctly differentiates the severity of depressive symptoms in the study group, is applicable to research among population-based samples.

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In individual diagnose and clinical practice, the CESD-R may be used as introductory tool, however, it is recommended to confirm the diagnosis.

References

1. Hasin D, Goodwin R, Stinson F, Grant B. Epidemiology of major depressive disorder:

results from the National Epidemiologic Survey on Alcoholism and Related Conditions.

Arch. Gen. Psychiatry 2005; 62: 1097-1106.

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2. Wojnar M, Dróżdż W, Araszkiewicz A, Latkowski B, Nawacka-Pawlaczyk D, Urbański R.

Badanie rozpowszechnienia zaburzeń depresyjnych wśród pacjentów zgłaszających się do lekarzy rodzinnych. Psychiatr. Prakt. Ogólnolek. 2002; 2: 187-197.

3. World Health Organization. Mental disorders. 2016. [dostęp:

http://www.who.int/mediacentre/factsheets/fs396/en/].

4. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561-571.

5. Parnowski T, Jernajczyk W. Inwentarz Depresji Becka w ocenie nastroju osób zdrowych i chorych na choroby afektywne (ocena pilotażowa). Psychiatr. Pol. 1977; 11: 417-425.

6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-5. Waszyngton: American Psychiatric Publishing, Inc.; 2013.

7. World Health Organization. The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1994.

8. Hamilton M. A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 1960; 23:

56-62.

9. Bagby M, Ryder A, Schuller D, Marshall MB. The Hamilton Depression Rating Scale:

has the gold standard become a lead weight? Am. J. Psychiatry 2004; 161: 2163-2177.

10. Williams J, Hirsch E, Anderson K, Bush AL, Goldstein SR, Grill S. i wsp. A comparison of nine scales to detect depression in Parkinson disease Which scale to use? Neurology 2012; 78: 998-1006.

11. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for

Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W:

Maruish ME red. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377

12. Montgomery S, Asberg M. A new depression scale designed to be sensilive to change.

Br. J. Psychiatry 1979; 134: 382-389.

13. Brzezińska U, Koć-Januchta M, Stańczak J. MMPI(R)-2. Podręcznik stosowania, oceny i interpretacji. Wersja zrewidowana. Warszawa: Pracownia Testów

Psychologicznych PTP; 2012.

14. Radloff L. The CES-D Scale: a self-report depression scale for research in the general population. Appl. Psychol. Meas. 1977; 1: 385-401.

15. Radloff L. The use of the Center for epidemiologic studies depression scale in adolescents and, young adults. J. Youth Adolesc. 1991; 20: 149-166.

16. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Waszyngton: American Psychiatric Publishing, Inc.; 2000.

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P. 1116

17. Van Dam N, Earleywine M. Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Res. 2011; 186: 128-132.

18. Brzeziński J. Metodologia badań psychologicznych. Warszawa: Wydawnictwo Naukowe PWN; 2006.

Address: Karolina Koziara

Institute of Psychology Jagiellonian University 30-060 Krakow, Ingardena Street 6

P. 1117 APPENDIX CESD-R

Authors: Eaton W, Muntaner C, Smith C. et al.

Translation: Koziara K. et al.

Poniżej znajduje się lista stwierdzeń dotyczących samopoczucia i zachowania, proszę zaznaczyć odpowiedź, która najlepiej oddaje Pana/Pani stan w ciągu ostatnich 2 tygodni.

0. wcale lub krócej niż 1 dzień 1. 1-2 dni

2. 3-4 dni 3. 5-7 dni

4. prawie codziennie przez 2 tygodnie 0 1 2 3 4 1. Miałem(am) kiepski apetyt. 0 1 2 3 4

2. Nie mogłem(am) pozbyć się chandry. 0 1 2 3 4

3. Miałem(am) problem ze skupieniem się na tym, co robię. 0 1 2 3 4 4. Czułem(am) się przygnębiony(a). 0 1 2 3 4

5. Mój sen był niespokojny. 0 1 2 3 4 6. Czułem(am) się smutny(a). 0 1 2 3 4

7. Nie mogłem(am) zebrać się do działania. 0 1 2 3 4 8. Nic mnie nie cieszyło. 0 1 2 3 4

9. Czułem(am) się złym człowiekiem. 0 1 2 3 4

10. Straciłem(am) zainteresowanie codziennymi zajęciami. 0 1 2 3 4

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11. Spałem(am) o wiele dłużej niż zazwyczaj. 0 1 2 3 4 12. Czułem(am) jakbym poruszał(a) się zbyt wolno. 0 1 2 3 4 13. Czułem(am) się niespokojny(a). 0 1 2 3 4

14. Chciałem(am) umrzeć. 0 1 2 3 4

15. Chciałem(am) zrobić sobie krzywdę. 0 1 2 3 4 16. Cały czas byłem(am) zmęczony(a). 0 1 2 3 4 17. Nie lubiłem(am) siebie. 0 1 2 3 4

18. Mimowolnie straciłem(am) dużo na wadze. 0 1 2 3 4 19. Miałem(am) problemy z zaśnięciem. 0 1 2 3 4

20. Nie mogłem(am) skupić się na ważnych rzeczach. 0 1 2 3 4 FOOTNOTES

Footnote 1. Hasin D, Goodwin R, Stinson F, Grant B. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch. Gen. Psychiatry 2005; 62: 1097-1106. Return to the main document

Footnote 2. Wojnar M, Dróżdż W, Araszkiewicz A, Latkowski B, Nawacka-Pawlaczyk D, Urbański R. Badanie rozpowszechnienia zaburzeń depresyjnych wśród pacjentów zgłaszających się do lekarzy rodzinnych. Psychiatr. Prakt. Ogólnolek. 2002; 2: 187-197.

Return to the main document

Footnote 3. World Health Organization. Mental disorders. 2016. [retrieved:

http://www.who.int/mediacentre/factsheets/fs396/en/]. Return to the main document

Footnote 4. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561-571. Return to the main document

Footnote 5. Parnowski T, Jernajczyk W. Inwentarz Depresji Becka w ocenie nastroju osób zdrowych i chorych na choroby afektywne (ocena pilotażowa). Psychiatr. Pol. 1977; 11:

417-425. Return to the main document

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Footnote 6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-5. Waszyngton: American Psychiatric Publishing, Inc.; 2013. Return to the main document

Footnote 7. World Health Organization. The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1994. Return to the main document

Footnote 8. Hamilton M. A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 1960; 23: 56-62. Return to the main document

Footnote 9. Bagby M, Ryder A, Schuller D, Marshall MB. The Hamilton Depression Rating Scale: has the gold standard become a lead weight? Am. J. Psychiatry 2004; 161: 2163- 2177. Return to the main document

Footnote 10. Williams J, Hirsch E, Anderson K, Bush AL, Goldstein SR, Grill S. i wsp. A comparison of nine scales to detect depression in Parkinson disease Which scale to use?

Neurology 2012; 78: 998-1006. Return to the main document

Footnote 8, 11, 12. Hamilton M. A rating scale for depression. J. Neurol. Neurosurg.

Psychiatry 1960; 23: 56-62; Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W: Maruish ME red. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377;

Montgomery S, Asberg M. A new depression scale designed to be sensitive to change. Br.

J. Psychiatry 1979; 134: 382-389. Return to the main document

Footnote 10. Williams J, Hirsch E, Anderson K, Bush AL, Goldstein SR, Grill S. i wsp. A comparison of nine scales to detect depression in Parkinson disease Which scale to use?

Neurology 2012; 78: 998-1006. Return to the main document

Footnote 13. Brzezińska U, Koć-Januchta M, Stańczak J. MMPI(R)-2. Podręcznik stosowania, oceny i interpretacji. Wersja zrewidowana. Warszawa: Pracownia Testów Psychologicznych PTP; 2012. Return to the main document

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Footnote 14. Radloff L. The CES-D Scale: a self-report depression scale for research in the general population. Appl. Psychol. Meas. 1977; 1: 385-401. Return to the main document

Footnote 14. Radloff L. The CES-D Scale: a self-report depression scale for research in the general population. Appl. Psychol. Meas. 1977; 1: 385-401. Return to the main document

Footnote 15. Radloff L. The use of the Center for epidemiologic studies depression scale in adolescents and, young adults. J. Youth Adolesc. 1991; 20: 149-166. Return to the main document

Footnote 16. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Waszyngton: American Psychiatric Publishing, Inc.; 2000.

Return to the main document

Footnote 11. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W:

Maruish ME red. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377. Return to the main document

Footnote 4. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561-571. Return to the main document

Footnote 5. Parnowski T, Jernajczyk W. Inwentarz Depresji Becka w ocenie nastroju osób zdrowych i chorych na choroby afektywne (ocena pilotażowa). Psychiatr. Pol. 1977; 11:

417-425. Return to the main document

Footnote 11. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W:

Maruish ME red. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377. Return to the main document

(17)

Footnote 11. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W:

Maruish ME red. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377. Return to the main document

Footnote 17. Van Dam N, Earleywine M. Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Res. 2011; 186: 128-132. Return to the main document

Footnote 1. Participants who claimed receiving psychological/psychiatric help. Return to the main document

Footnote 2. Participants who denied receiving psychological/psychiatric help. Return to the main document

Footnote 3. Participants who claimed receiving psychological/psychiatric help. Return to the main document

Footnote 4. Participants who denied receiving psychological/psychiatric help. Return to the main document

Footnote 4, 5. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561-571; Parnowski T, Jernajczyk W. Inwentarz Depresji Becka w ocenie nastroju osób zdrowych i chorych na choroby afektywne (ocena pilotażowa). Psychiatr. Pol. 1977; 11: 417-425. Return to the main document

Footnote 18. Brzeziński J. Metodologia badań psychologicznych. Warszawa:

Wydawnictwo Naukowe PWN; 2006. Return to the main document

Footnote 11. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A, Maruish ME. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). W:

Maruish ME red. The use of psychological testing for treatment planning and outcomes

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assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. s. 363-377. Return to the main document

Footnote 18. Brzeziński J. Metodologia badań psychologicznych. Warszawa:

Wydawnictwo Naukowe PWN; 2006. Return to the main document

Footnote 17. Van Dam N, Earleywine M. Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Res. 2011; 186: 128-132. Return to the main document

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