Translation and Psychometric Properties of Center for Epidemiological Studies Depression-Revised (CESD-R) Scale in Urdu

Abstract

Depression is recognized as one of the leading causes of disability worldwide, with particularly high prevalence in low- and middle-income countries such as Pakistan. Addressing this burden requires valid and culturally adapted instruments for screening and research. The present study aimed to translate the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) into Urdu and evaluate its psychometric properties in Pakistani populations. The translation process followed internationally accepted guidelines, including back-translation and expert committee review, to ensure linguistic and conceptual equivalence. Two samples were recruited: a general population sample (N = 214) and a bilingual sample (N = 70). Results demonstrated strong internal consistency (Cronbach’s α = .88) and high test–retest reliability (.81–.93), indicating temporal stability. Exploratory factor analysis suggested two factors—affective/functional impairment and self-destructive pattern—though a one-factor model was endorsed for parsimony and practical use. Differential item functioning revealed one item varied significantly across gender, highlighting potential cultural differences in symptom expression. Overall, findings provide preliminary evidence that the CESD-R (Urdu) is a reliable and valid self-report screening tool for depression in Pakistan. This adaptation offers researchers and practitioners a culturally relevant instrument to facilitate community-based surveys and mental health research, while underscoring the need for further validation in larger, representative samples.