Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-23T23:14:42.590Z Has data issue: false hasContentIssue false

Clinical validation of the Psychotic Depression Assessment Scale (PDAS) against independent global severity ratings in older adults

Published online by Cambridge University Press:  04 March 2018

Tom Vermeulen*
Affiliation:
University Psychiatric Hospital Duffel, Duffel, Belgium Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
Lieve Lemey
Affiliation:
General Hospital Sint Jan Brugge-Oostende AV, Brugge, Belgium
Linda Van Diermen
Affiliation:
University Psychiatric Hospital Duffel, Duffel, Belgium Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
Didier Schrijvers
Affiliation:
University Psychiatric Hospital Duffel, Duffel, Belgium Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium Department of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
Yamina Madani
Affiliation:
University Psychiatric Hospital Duffel, Duffel, Belgium
Bernard Sabbe
Affiliation:
University Psychiatric Hospital Duffel, Duffel, Belgium Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
Maarten J.A. Van Den Bossche
Affiliation:
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium Medical Centre Sint Jozef, Munsterbilzen, Belgium
Roos C. van der Mast
Affiliation:
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Søren D. Østergaard
Affiliation:
Psychosis Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
*
Author for correspondence: Tom Vermeulen, Psychiatric Hospital Duffel, Stationsstraat 22c, 2570 Duffel, Belgium. Tel: 0032 15 304974; Fax: 0032 15 304047;E-mail: tom.vermeulen@emmaus.be

Abstract

Objectives

According to a recent study, ratings on the Psychotic Depression Assessment Scale (PDAS) obtained via a dedicated semi-structured interview are valid measures of the severity of psychotic depression. This study aimed to further test the validity, scalability and responsiveness of the PDAS in older adults using independent ratings on the Clinical Global Impression Scale – Severity (CGI-S) and the Montgomery-Asberg Depression Rating Scale (MADRS) as references.

Methods

Ratings were performed at admission and discharge at two old age psychiatric wards in Flanders, Belgium. In total, 62 older adults (mean age: 74.3 years) with psychotic depression were included. The PDAS was rated by trained nurses using the semi-structured PDAS interview. Senior psychiatrists scored the participants on the CGI-S. Psychologists or experienced nurses rated participants on the MADRS. Clinical validity was assessed by correlating the PDAS total scores with CGI-S ratings and MADRS total scores. Mokken analysis was performed to assess the scalability of the PDAS. Responsiveness was assessed by comparing the proportion of participants in remission (PDAS total score <8 at study baseline and endpoint).

Results

The Spearman correlation coefficients were 0.76 and 0.79 for the PDAS versus CGI-S and PDAS versus MADRS, respectively. The Mokken analysis yielded a Loevinger coefficient of 0.46, which is indicative of scalability. At admission, no participants met the PDAS remission criterion. At discharge, 54% (95% confidence interval: 47%–60%) of the patients met this criterion.

Conclusion

The PDAS appears to be a clinically valid, scalable and responsive measure of the severity of psychotic depression in older adults.

Type
Original Article
Copyright
© Scandinavian College of Neuropsychopharmacology 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Gournellis, R, Lykouras, L, Fortos, A, Oulis, P, Roumbos, V Christodoulou, GN (2001) Psychotic (delusional) major depression in late life: a clinical study. Int J Geriatr Psychiatry 16, 10851091.Google Scholar
2. Gournellis, R, Oulis, P Howard, R (2014) Psychotic major depression in older people: a systematic review. Int J Geriatr Psychiatry 29, 789796.Google Scholar
3. Gournellis, R, Oulis, P, Michalopoulou, P, Kaparoudaki, A, Dimitrakopoulos, C Lykouras, L (2009) Dimensional approach to delusions in psychotic depression in the elderly: factor structure and clinical correlates. Int J Geriatr Psychiatry 24, 363368.Google Scholar
4. Lykouras, L, Gournellis, R, Fortos, A, Oulis, P Christodoulou, GN (2002) Psychotic (delusional) major depression in the elderly and suicidal behaviour. J Affect Disord 69, 225229.Google Scholar
5. Leadholm, AKK, Rothschild, AJ, Nolen, WA, Bech, P, Munk-Jørgensen, P Østergaard, SD (2013) The treatment of psychotic depression: is there consensus among guidelines and psychiatrists? J Affect Disord 145, 214–220.Google Scholar
6. Rothschild, AJ (2003) Challenges in the treatment of depression with psychotic features. Biol Psychiatry 53, 680–690.Google Scholar
7. Rothschild, AJ. Clinical Manual for Diagnosis and Treatment of Psychotic Depression. Washington: American Psychiatric Publishing, 2009.Google Scholar
8. Hamilton, M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6, 278296.Google Scholar
9. Montgomery, SA Asberg, M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134, 382.Google Scholar
10. Ostergaard, SD, Rothschild, AJ, Flint, AJ, Mulsant, BH, Whyte, EM Leadholm, AK, Bech , P Meyers, BS (2015) Rating scales measuring the severity of psychotic depression. Acta Psychiatr Scand 132, 335344.Google Scholar
11. Østergaard, SD, Meyers, BS, Flint, AJ, Mulsant, BH, Whyte, EM, Ulbricht, CM, Bech, P Rotschild, AJ; on behalf of the STOP-PD Study Group (2014) Measuring psychotic depression. Acta Psychiatr Scand 129, 211220.Google Scholar
12. Overall, JE Gorham, DR (1962) The brief psychiatric rating scale. Psychol Rep 10, 799812.Google Scholar
13. Ostergaard, SD, Meyers, BS, Flint, AJ, Mulsant, BH, Whyte, EM, Ulbricht, CM, Bech, P Rotschild, AJ; on behalf of the STOP-PD Study Group (2014) Measuring treatment response in psychotic depression: the Psychotic Depression Assessment Scale (PDAS) takes both depressive and psychotic symptoms into account. J Affect Disord 160, 6873.Google Scholar
14. Ostergaard, SD, Pedersen, CH, Uggerby, P, Munk-Jorgensen, P, Rothschild, AJ, Larsen, JI, Gotzsche, C, Sondergaard, MG, Bille, AG, Bolwig, TG, Larsen, JK Bech, P (2015) Clinical and psychometric validation of the psychotic depression assessment scale. J Affect Disord 173, 261268.Google Scholar
15. Bech, P, Gram, L, Dein, E, Jacobsen, O, Vitger, J Bolwig, T (1975) Quantitative rating of depressive states. Acta Psychiatr Scand 51, 161170.Google Scholar
16. Timmerby, N, Andersen, JH, Sondergaard, S, Ostergaard, SD Bech, P (2017) A systematic review of the clinimetric properties of the 6-item version of the Hamilton Depression Rating Scale (HAM-D6). Psychother Psychosom 86, 141149.Google Scholar
17. Ostergaard, SD, Rothschild, AJ, Flint, AJ, Mulsant, BH, Whyte, EM, Vermeulen, T, Bech, P Meyers, BS (2016) Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS). J Affect Disord 190, 111114.Google Scholar
18. Köse Çinar, R Dinesen Østergaard, S (2017) Validation of the semi-structured Psychotic Depression Assessment Scale (PDAS) interview. Acta Neuropsychiatr 16.Google Scholar
19. Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R Dunbar, JC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl. 20), 2233. quiz 4–57.Google Scholar
20. Borza, T, Engedal, K, Bergh, S, Benth, Selbæk, G (2015) The course of depression in late life as measured by the Montgomery and Asberg Depression Rating Scale in an observational study of hospitalized patients. BMC Psychiatry 15, 191.Google Scholar
21. Engedal, K, Kvaal, K, Korsnes, M, Barca, ML, Borza, T, Selbaek, G Aakhus, E (2012) The validity of the Montgomery-Aasberg depression rating scale as a screening tool for depression in later life. J Affect Disord 141, 227232.Google Scholar
22. Kadouri, A, Corruble, E Falissard, B (2007) The improved Clinical Global Impression Scale (iCGI): development and validation in depression. BMC Psychiatry 7, 7.Google Scholar
23. Bech, P (2012) Clinical psychometrics. Oxford: John Wiley & Sons.Google Scholar
24. Park, SC, Ostergaard, SD, Choi, J, Kim, JM, Jun, TY, Lee, MS, Kim, J-B, Yim, H-W Park, YC (2015) Is the BPRS-5 subscale of the psychotic depression assessment scale a reliable screening tool for psychotic depression?: Results from the CRESCEND study. J Affect Disord 174, 188191.Google Scholar
25. Molenaar, I, Debels, P Sijtsna, K (1994) User’s manual MSP, a program for Mokken Scale analyses for polytomous items (Version 3.0). Groeningen, The Netherlands: ProGAMMA.Google Scholar
26. Rothschild, AJ, Winer, J, Flint, AJ, Mulsant, BH, Whyte, EM, Heo, M, Fratoni, S, Gabriele, M, Kasapinovic, S Meyers, BS (Study of Pharmacotherapy of Psychotic Depression) (2008) Missed diagnosis of psychotic depression at 4 academic medical centers. J Clin Psychiatry 69, 12931296.Google Scholar
27. Victoria, LW, Whyte, EM, Butters, MA, Meyers, BS, Alexopoulos, GS, Mulsant, BH Flint, AJ (2017) Improvement in depression is associated with improvement in cognition in late-life psychotic depression. Am J Geriatr Psychiatry 25, 672679.Google Scholar
28. Bingham, KS, Whyte, EM, Meyers, BS, Mulsant, BH, Rothschild, AJ, Banerjee, S Flint, AJ; on behalf of the STOP-PD Study Group (2015) Relationship between cerebrovascular risk, cognition, and treatment outcome in late-life psychotic depression. Am J Geriatr Psychiatry 23, 12701275.Google Scholar