[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-ces-dc":3,"all-assessments-nav":243,"related-assessments-query":923},{"id":4,"title":5,"body":6,"category":185,"categoryTitle":186,"clinicalCitations":187,"copyright":185,"description":197,"disclaimer":185,"downloadLink":185,"extension":198,"faqs":199,"featured":215,"i18nReady":215,"icon":185,"interpreter":216,"lastReviewed":233,"meta":234,"navigation":235,"path":236,"permissionsNote":185,"published":235,"recommendedFrequency":185,"relatedCodes":185,"relatedConditions":185,"reviewedBy":185,"seo":237,"slug":238,"stem":239,"summary":240,"takeaways":185,"timeline":185,"type":241,"usedToDiagnose":185,"__hash__":242},"assessments\u002Fassessments\u002Fces-dc.md","CES-DC Scoring · Center for Epidemiologic Studies Depression Scale for Children",{"type":7,"value":8,"toc":170},"minimark",[9,13,18,21,24,28,31,36,40,56,60,96,99,103,106,110,113,117,139,158,162],[10,11,12],"p",{},"The CES-DC is a free, 20-item self-report screener for depressive symptoms in children and adolescents, adapted from the widely used adult CES-D.",[14,15,17],"h3",{"id":16},"about-the-ces-dc","About the CES-DC",[10,19,20],{},"The Center for Epidemiologic Studies Depression Scale for Children was adapted by Myrna Weissman and colleagues from the adult Center for Epidemiologic Studies Depression Scale (CES-D), itself developed by Lenore Radloff. The child version keeps the same 20-item structure but rephrases the items in plain language a young person can answer about how they have felt over the past week.",[10,22,23],{},"It is a self-report screen for children and adolescents roughly ages 6 to 17, and because it is in the public domain it is widely used at no cost in schools, primary care, and epidemiological research. The CES-DC measures depressive symptom burden rather than confirming any condition.",[14,25,27],{"id":26},"what-the-ces-dc-measures","What the CES-DC Measures",[10,29,30],{},"The CES-DC covers the core symptom areas of depression as experienced over the past week — depressed mood, loss of interest, feelings of worthlessness, appetite and sleep disturbance, fatigue, and difficulty concentrating — together with a few positively framed items about positive affect. It is a severity and screening measure, not a structured clinical interview.",[32,33,35],"h2",{"id":34},"ces-dc-scoring-interpretation","CES-DC Scoring & Interpretation",[14,37,39],{"id":38},"how-to-score-the-ces-dc","How to Score the CES-DC",[10,41,42,43,47,48,51,52,55],{},"Each item is rated ",[44,45,46],"strong",{},"0 (Not At All), 1 (A Little), 2 (Some), or 3 (A Lot)"," for the past week. Four positively worded items (covering positive affect, such as feeling happy, hopeful, or enjoying life) are ",[44,49,50],{},"reverse-scored",", then all 20 items are summed for a ",[44,53,54],{},"total ranging 0–60",". Higher scores indicate greater depressive symptom burden. Use the interpreter above to place a total against the screening threshold.",[14,57,59],{"id":58},"ces-dc-cut-points","CES-DC Cut-Points",[61,62,63,76],"table",{},[64,65,66],"thead",{},[67,68,69,73],"tr",{},[70,71,72],"th",{},"Range",[70,74,75],{},"Interpretation",[77,78,79,88],"tbody",{},[67,80,81,85],{},[82,83,84],"td",{},"0–14",[82,86,87],{},"Below screening threshold",[67,89,90,93],{},[82,91,92],{},"≥15",[82,94,95],{},"Positive screen — supports referral for full evaluation",[10,97,98],{},"A total of ≥15 is the screening threshold suggested for current depressive disorder (Fendrich et al., 1990). The scale has limited specificity — many children scoring above 15 will not meet criteria for a depressive disorder on full assessment — so the cut-off is best read as a trigger for closer evaluation, applied with clinical judgement. A positive screen is a screening result, not a clinical conclusion.",[14,100,102],{"id":101},"administration","Administration",[10,104,105],{},"The CES-DC takes about 5 minutes and is completed by the young person. Non-clinical staff can administer it, but a licensed clinician interprets the score alongside history, development, and functional context. For younger children, pair self-report with caregiver observation, since self-report reliability is lower below early adolescence.",[14,107,109],{"id":108},"psychometric-properties","Psychometric Properties",[10,111,112],{},"The CES-DC shows good internal consistency and correlates with clinician-rated depression and with other youth depression measures, supporting its reliability and concurrent validity, with the strongest performance in adolescents aged 12 to 18 and in girls (Fendrich et al., 1990; Faulstich et al., 1986). Its main weakness is limited specificity, which is why it is positioned as a screen rather than a confirmatory measure.",[14,114,116],{"id":115},"limitations","Limitations",[118,119,120,127,133],"ul",{},[121,122,123,126],"li",{},[44,124,125],{},"Screening, not a clinical conclusion."," A positive CES-DC indicates symptoms consistent with depression and warrants full evaluation.",[121,128,129,132],{},[44,130,131],{},"Limited specificity."," Elevated scores also occur with anxiety and other distress, producing false positives.",[121,134,135,138],{},[44,136,137],{},"Age and reliability."," Self-report is less reliable in younger children; caregiver input matters below early adolescence.",[10,140,141,142,147,148,152,153,157],{},"For adolescent depression with parent-report options, consider the ",[143,144,146],"a",{"href":145},"\u002Fassessments\u002Fmfq\u002F","MFQ","; for adults, use the ",[143,149,151],{"href":150},"\u002Fassessments\u002Fphq-9\u002F","PHQ-9","; for co-occurring anxiety in youth, the ",[143,154,156],{"href":155},"\u002Fassessments\u002Fscared\u002F","SCARED",".",[32,159,161],{"id":160},"billing-the-ces-dc-cpt-96127","Billing the CES-DC (CPT 96127)",[10,163,164,165,169],{},"CES-DC administration qualifies for reimbursement under ",[143,166,168],{"href":167},"\u002Fcpt-codes\u002F96127-brief-emotional-behavioural-assessment\u002F","CPT code 96127"," (brief emotional\u002Fbehavioural assessment) when it is scored and documented with clinical interpretation. The AMA allows up to 4 units per encounter; Medicare limits this to 3.",{"title":171,"searchDepth":172,"depth":172,"links":173},"",3,[174,175,176,184],{"id":16,"depth":172,"text":17},{"id":26,"depth":172,"text":27},{"id":34,"depth":177,"text":35,"children":178},2,[179,180,181,182,183],{"id":38,"depth":172,"text":39},{"id":58,"depth":172,"text":59},{"id":101,"depth":172,"text":102},{"id":108,"depth":172,"text":109},{"id":115,"depth":172,"text":116},{"id":160,"depth":177,"text":161},null,"Depression & Mood",[188,191,194],{"text":189,"link":190},"Weissman MM, Orvaschel H, Padian N. Children's symptom and social functioning self-report scales: comparison of mothers' and children's reports. J Nerv Ment Dis. 1980;168(12):736-740.","https:\u002F\u002Fdoi.org\u002F10.1097\u002F00005053-198012000-00005",{"text":192,"link":193},"Fendrich M, Weissman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990;131(3):538-551.","https:\u002F\u002Fdoi.org\u002F10.1093\u002Foxfordjournals.aje.a115529",{"text":195,"link":196},"Faulstich ME, Carey MP, Ruggiero L, et al. Assessment of depression in childhood and adolescence: an evaluation of the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Am J Psychiatry. 1986;143(8):1024-1027.","https:\u002F\u002Fdoi.org\u002F10.1176\u002Fajp.143.8.1024","CES-DC scoring guide — Center for Epidemiologic Studies Depression Scale for Children. 20 items 0–3, total 0–60, positive screen ≥15. Free.","md",[200,203,206,209,212],{"question":201,"answer":202},"What is the CES-DC?","The CES-DC is a free, 20-item self-report screener for depressive symptoms in children and adolescents, adapted by Myrna Weissman and colleagues from the adult Center for Epidemiologic Studies Depression Scale (CES-D). It asks how often the young person has felt or acted a certain way over the past week and is in the public domain, making it a common no-cost depression screen for ages 6 to 17.",{"question":204,"answer":205},"How is the CES-DC scored?","Each of the 20 items is rated 0 (Not At All), 1 (A Little), 2 (Some), or 3 (A Lot) for the past week. Four positively worded items are reverse-scored, then all items are summed for a total ranging 0–60. Higher scores indicate more depressive symptoms.",{"question":207,"answer":208},"What is the cut-off score for the CES-DC?","A total score of 15 or higher is the screening threshold suggested for current depressive disorder in children and adolescents (Fendrich et al., 1990). The CES-DC has limited specificity, so many children who score above 15 will not have a depressive disorder on full assessment. A positive screen warrants a full clinical evaluation, not a screening result treated as a conclusion.",{"question":210,"answer":211},"What ages is the CES-DC for?","The CES-DC is designed for children and adolescents roughly ages 6 to 17, with the validation work supporting it most strongly for those aged 12 to 18 and for girls. For younger children, self-report depression measures are less reliable and caregiver input is important; for adults, use the PHQ-9.",{"question":213,"answer":214},"Is the CES-DC free to use?","Yes. The CES-DC is in the public domain and free for clinical, educational, and research use, with no licensing fees, which is part of why it is widely used in schools, primary care, and research.",false,{"heading":217,"scaleLabel":218,"min":219,"max":220,"start":221,"note":222,"source":223,"bands":224},"CES-DC Score Interpreter (20-item, 0–60)","CES-DC total",0,60,15,"A total of ≥15 is the screening threshold suggested for current depressive disorder in children and adolescents (Fendrich et al., 1990). The CES-DC has limited diagnostic specificity, so a positive screen warrants a full clinical evaluation — it is a screening result, not a clinical conclusion.","Center for Epidemiologic Studies Depression Scale for Children (Weissman et al., 1980; Fendrich et al., 1990). Screening reference only.",[225,229],{"min":219,"label":226,"note":227,"level":228},"Below screening threshold (0–14)","Depressive symptoms not elevated on the CES-DC.","success",{"min":221,"label":230,"note":231,"level":232},"Positive screen (≥15)","At or above the screening threshold; supports referral for full evaluation.","error","2026-06-07",{},true,"\u002Fassessments\u002Fces-dc",{"title":5,"description":197},"ces-dc","assessments\u002Fces-dc","CES-DC scoring guide — the Center for Epidemiologic Studies Depression Scale for Children, a free 20-item self-report screener for depressive symptoms in children and adolescents. 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