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La recherche d’une mesure unidimensionnelle de la dépression: à propos de l’échelle de dépression de Hamilton

Published online by Cambridge University Press:  28 April 2020

P. Cialdella
Affiliation:
Unité Notre-Dame (service du Dr Escolier), hôpital Saint-Jean-de-Dieu, 290, route de Vienne, 69008Lyon
O. Chambon
Affiliation:
Laboratoire de psychologie médicale (service du Pr Dalery), hôpital neurologique, boulevard Pinel, 69500Bron
J.P. Boissel
Affiliation:
Unité de pharmacologie clinique, 162, avenue Lacassagne, 69424Lyon Cedex 03
E. Ravet-Cialdella
Affiliation:
Service du Pr Coudert, hôpital Saint-Jacques, 2, place Henri-Dunant, 63000Clermont-Ferrand, France
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Résumé

L’utilisation du score global d’une échelle d’évaluation suppose l’unidimensionnalité de l’instrument, avantage censé permettre une plus grande puissance des tests statistiques. Classiquement, la vérification de cette propriété reposait sur l’isolement par l’analyse factorielle d’un facteur général, en rapport avec le pourcentage de variance extraite, mais aucun critère de choix du nombre de facteurs n’a été universellement accepté. De plus, les résultats d’une analyse donnée sont très dépendants des caractéristiques de l’échantillon, et non généralisables. Les récentes théories du trait latent, dont la plus connue est le modèle de Rasch (1960) preséntent l’avantage d’estimer la position des items sur une dimension (Fig. 1) indépendamment des caractéristiques (par exemple, diagnostiques) de l’échantillon et de procurer un test d’ajustement du modèle donnant un indice d’unidimensionnalité. La revue des analyses factorielles de l’échelle de dépression de Hamilton (HDS, 1960) montre qu’aucune étude n’a permis d’isoler un facteur général de dépression, qui autoriserait l’usage du score global de la HDS comme mesure de l’intensité de la dépression. Plus grave, les structures factorielles sont apparues comme généralement instables. En utilisant le modèle de Rasch, Bech a pu constater que 6 items extraits de la HDS remplissaient les critères d’unidimensionnalité, mais non l’échelle totale. Ces 6 items composent dorénavant une partie de la Bech-Rafaelsen Melancholia Scale (BRMES), dont l’unidimensionnalité a été récemment vérifiée par Maier & Philipp (1985), au sens du modèle de Rasch. L’analyse factorielle et le modèle de Rasch convergent donc vers la conclusion que l’utilisation du score global de la HDS ne se justifie plus, mais le modèle de Rasch semble appuyer la validite de la note globale de la BRMES comme mesure stable de la sévérité de la dépression.

Summary

Summary

The use of a rating scale global score assumes the unidimensionality of the instrument, with the theoretical benefit of increased power for the statistical tests. Classically, this property was checked by means of factor analysis: if a single general factor was appearing, depending on the proportion of extracted variance, it was generally considered as synonymous of unidimensionality, but no criterion for the choice of the number of factors has yet been universally accepted. Moreover, the results of a given analysis depend closely on the characteristics of the sample, and thus are not generalisable. The recent theories of Latent Trait, the most famous of these being the Rasch model (1960), share the advantage of yielding estimations of item parameters along the dimension (Fig. 1) independently from the characteristics (for instance, diagnostical) of the sample; furthermore, the goodness-of-fit test of the model provides an index of unidimensionality. A review of the main factor analyses carried out with the Hamilton Depression Scale (HDS, 1960) shows that no single replicable general factor has ever been found, which, if present, would have justified the use of the HDS global score as a valid assessment of depression severity. More worrying, the HDS factor structures have generally appeared to be unstable. By means of a Rasch model, Bech found that 6 items extracted from the HDS fullfilled the criteria of unidimensionality, but not the whole scale. These 6 items currently constitute a part of the Bech-Rafaelsen Melancholia Scale (BRMES), the unidimensionality of which has recently been verified by Maier & Philip (1985), with a Rasch model. Factor analyses and Rasch models indicate that the use of HDS global score is no longer justified, although the Rasch model seems to support the validity of the BRMES global score as a good assessment of depression severity.

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Article original
Copyright
Copyright © European Psychiatric Association 1989

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References

Références

Baker, F.B. (1987) Methodology review: item parameter estimation under the one-, two-, and three-parameter logistic models. Appl. Psychol. Meas. 11, 2, 111141CrossRefGoogle Scholar
Bech, P., Gram, L.F., Dein, E., Jacobsen, O., Vitger, J. & Bolwig, T.G. (1975) Quantitative rating of depressive States. Acta Psychiatr. Scand. 51, 161170CrossRefGoogle ScholarPubMed
Bech, P. & Rafaelsen, O. J. (1980) The use of rating scales exemplified by a comparison of the Hamilton and the Bech-Rafaelsen melancholia scale. Acta Psychiatr. Scand. suppl. 285, 128131CrossRefGoogle Scholar
Bech, P. (1981a Rating scales for affective disorders : their validity and consistency. Acta Psychiatr. Scand. suppl. 295, 1191Google Scholar
Bech, P., Allerup, P., Gram, L.F., Reisby, N., Rosenberg, R., Jacobsen, O. & Nagy, A. (1981b The Hamilton depression scale : evaluation of objectivity using logistic models. Acta Psychiatr. Scand. 63, 290299CrossRefGoogle Scholar
Bech, P. (1988) Dimensions de la dépression : modeles statistiques pour l’évaluation des troubles affectifs. Psychiatr. Psychobiol. 3, 37s44sGoogle Scholar
Bech, P., Kastrup, M. & Rafaelsen, O.J. (1989) Echelles des etats d’anxiété, de depression, de manie, de schizophrenie. Correspondance avec les syndromes du DSM-III. Masson, Paris (à paraître)Google Scholar
Bouman, T.K. & Kok, A.R. (1987) Homogeneity of Beck's Depression Inventory (BDI) : Applying Rasch analysis in conceptual exploration. Acta Psychiatr. Scand. 76, 568573CrossRefGoogle ScholarPubMed
Carmines, E.G. & Zeller, R. A. (1979) Reliahility and Validity Assessment. SAGE University Papers., Beverly Hills, USACrossRefGoogle Scholar
Chambon, O., Poncet, F., Kiss, L., Milani, D. & Cottraux, J. (1989) Adaptation francaise, validation concurrente et analyse factorielle de l’échelle de mélancolie de Bech et Rafaelsen. Encéphale (à paraître)Google Scholar
Cialdella, Ph., Guillaud-Bataille, J.M. & Gausset, M.F. (1989) Application du modèle de Rasch à une échelle de dèpression du sujet âgé, la Geriatrie Depression Scale (GDS). Communication aux Journées d’informatique médicale de Toulouse (24-26 mai)Google Scholar
Cleary, P. & Guy, M. (1976) Factor analysis of the Hamilton depression scale. In: ECDEU Assessment Manual for Psychopharmacology (Guy, W., ed.) National Institute of Mental Health, Rockville, Maryland, USAGoogle Scholar
Cleary, P. & Guy, M. (1977) Factor analysis of Hamilton Depression Scale. Drugs. Exp. Clin. Res. 1, 115120Google Scholar
Comrey, A.L. (1978) Common methodological problems in factor analytic studies. J. Consult. Clin. Psychol. 46, 4, 648659CrossRefGoogle Scholar
Cronbach, L.J. (1951) Coefficient alpha and the internai structure of tests. Psychometrika 16, 297334CrossRefGoogle Scholar
Cronholm, B. & Ottosson, J.O. (1960) Experimental studies of the therapeutic action of electroconvulsive therapy in endogenous depression. The role of electrical stimulation and the seizure studied by variation of stimulus and modification by lidocaine of seizure discharge. In: Experimental Studies of the Mode of Action of Electroconvulsive Treatment. (Ottosson J.O., ed.) Acta Psychiatr. Neurol. Scand. suppl. 145, 6997Google Scholar
Dreyfus, J.F., Guelfi, J.D., Ruschel, S., Blanchard, C. & Pichot, P. (1981) Structure factorielle de l’échelle de dépression de Hamilton. II. Ann. Med. Psychol. (Paris) 139, 446453Google Scholar
Gibbons, R.D., Clark, D.C., Von Ammon Cavanaugh, S. & Davis, J.M. (1985) Application of modem psychometric theory in psychiatrie research. J. Psychiatr. Res. 19, 1, 4355CrossRefGoogle Scholar
Grayson, D.A., Bridges, K., Duncan-Jones, P. & Goldberg, D.P. (1987) The relationship between symptoms and diagnoses of minor psychiatrie disorders in general practice. Psychol. Med. 17, 933942CrossRefGoogle Scholar
Grayson, D.A. (1988) Limitations on the use of scales in psychiatrie research. Aus. N. Z. J. Psychiatry 22, 99108CrossRefGoogle Scholar
Guelfi, J.D., Dreyfus, J.F., Ruschel, S., Blanchard, C. & Pichot, P. (1981) Structure factorielle de l’echelle de depression de Hamilton. I. Ann. Med. Psychol. (Paris) 139, 199214Google Scholar
Hamilton, M. (1960) A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 23, 5662CrossRefGoogle ScholarPubMed
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. Br. J. Soc. Clin. Psychol. 6, 278296CrossRefGoogle ScholarPubMed
Harman, H.H. (1979) Modem Factor Analysis. University of Chicago Press, Chicago, USAGoogle Scholar
Hattie, J. (1985) Methodology review : assessing unidimensionality of tests and items. Appl. Psychol. Meas. 9, 2, 139164CrossRefGoogle Scholar
Kaiser, H.F. (1958) The varimax criterion for analytic rotation in factor analysis. Psychometrika 23, 187200CrossRefGoogle Scholar
Kaiser, H.F. (1970) A second generation little jiffy. Psychometrika 35, 401415CrossRefGoogle Scholar
Lewine, R.R.J., Fogg, L., Meltzer, H.Y. (1985) Assessment of negative and posivite symptoms in schizophrenia. Schizophr. Bull. 9, 3, 368376CrossRefGoogle Scholar
Lord, F.M. (1980) Applications of Item Response Theory to Practical Testing Problems. Lawrence Erlbaum, Hillsdale, NJ, USAGoogle Scholar
Maier, W. & Philipp, M. (1985) Comparative analysis of observer depression scales. Acta Psychiatr. Scand. 72, 239245CrossRefGoogle ScholarPubMed
Mendels, J. & Cochrane, C. (1968) The nosology of depression: the endogenous-reactive concept. Am. J. Psychiatry 124, 11, 111CrossRefGoogle ScholarPubMed
Nunnaly, J.C. (1978) Psychometric Theory. McGraw-Hill, New York, USAGoogle Scholar
O’Brien, K.P. & Glaudin, V. (1988) Factorial structure and factor reliability of the Hamilton Rating Scale for Depression. Acta Psychiatr. Scand. 78, 113120CrossRefGoogle ScholarPubMed
Rasch, G. (1960) Probabilistic Models for some Intelligence and Attainment Tests. The Danish Institute for Educational Research, Copenhagen, DanemarkGoogle Scholar
Wright, B.D. & Stone, M.H. (1979) Best test design: Rasch measurement. Mesa Press, Chicago, USAGoogle Scholar
Zwick, W.R. & Velicer, W.F. (1986) Comparison of five rules for determining the number of components to retain. Psychol. Bull. 99, 3, 432442CrossRefGoogle Scholar
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