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Measuring depression: comparison and integration of three scales in the GENDEP study

Published online by Cambridge University Press:  09 October 2007

R. Uher ,
A. Farmer ,
W. Maier ,
M. Rietschel ,
J. Hauser ,
A. Marusic ,
O. Mors ,
A. Elkin ,
R. J. Williamson  and
C. Schmael
...Show all authors
R. Uher*
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
A. Farmer
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
W. Maier
Affiliation:
Rheinische Friedrich-Wilhelms-Universität Bonn, Germany
M. Rietschel
Affiliation:
Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany
J. Hauser
Affiliation:
Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
A. Marusic
Affiliation:
Institute of Public Health, Ljubljana, Slovenia
O. Mors
Affiliation:
Aarhus University Hospital, Risskov, Denmark
A. Elkin
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
R. J. Williamson
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
C. Schmael
Affiliation:
Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany
N. Henigsberg
Affiliation:
Croatian Institute for Brain Research, Medical School, University of Zagreb, Croatia
J. Perez
Affiliation:
Biological Psychiatry Unit and Dual Diagnosis Ward IRCCS, Centro San Giovanni di Dio, FBF, Brescia, Italy
J. Mendlewicz
Affiliation:
Free University of Brussels, Department of Psychiatry, Belgium
J. G. E. Janzing
Affiliation:
Department of Psychiatry, Nijmegen, The Netherlands
A. Zobel
Affiliation:
Rheinische Friedrich-Wilhelms-Universität Bonn, Germany
M. Skibinska
Affiliation:
Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
D. Kozel
Affiliation:
Institute of Public Health, Ljubljana, Slovenia
A. S. Stamp
Affiliation:
Aarhus University Hospital, Risskov, Denmark
M. Bajs
Affiliation:
Croatian Institute for Brain Research, Medical School, University of Zagreb, Croatia
A. Placentino
Affiliation:
Biological Psychiatry Unit and Dual Diagnosis Ward IRCCS, Centro San Giovanni di Dio, FBF, Brescia, Italy
M. Barreto
Affiliation:
Free University of Brussels, Department of Psychiatry, Belgium
P. McGuffin
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
K. J. Aitchison
Affiliation:
Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: R. Uher, PO80 SGDP, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales.

Method

The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery–Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores.

Results

The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely ‘observed mood and anxiety’, ‘cognitive’ and ‘neurovegetative’, provided a more detailed description of depression severity.

Conclusions

The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.

Keywords

Depressionitem response theoryrandomized controlled trialrating scales
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 2 , February 2008 , pp. 289 - 300
Copyright
Copyright © Cambridge University Press 2007

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