Skip to main content
×
×
Home

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

  • Tom Vermeulen (a1) (a2), Lieve Lemey (a3), Linda Van Diermen (a1) (a2), Didier Schrijvers (a1) (a2) (a4), Yamina Madani (a1), Bernard Sabbe (a1) (a2), Maarten J.A. Van Den Bossche (a2) (a5), Roos C. van der Mast (a2) (a6) and Søren D. Østergaard (a7) (a8)...
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.

Copyright
Corresponding author
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
References
Hide All
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.
2. Gournellis, R, Oulis, P Howard, R (2014) Psychotic major depression in older people: a systematic review. Int J Geriatr Psychiatry 29, 789796.
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.
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.
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.
6. Rothschild, AJ (2003) Challenges in the treatment of depression with psychotic features. Biol Psychiatry 53, 680–690.
7. Rothschild, AJ. Clinical Manual for Diagnosis and Treatment of Psychotic Depression. Washington: American Psychiatric Publishing, 2009.
8. Hamilton, M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6, 278296.
9. Montgomery, SA Asberg, M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134, 382.
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.
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.
12. Overall, JE Gorham, DR (1962) The brief psychiatric rating scale. Psychol Rep 10, 799812.
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.
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.
15. Bech, P, Gram, L, Dein, E, Jacobsen, O, Vitger, J Bolwig, T (1975) Quantitative rating of depressive states. Acta Psychiatr Scand 51, 161170.
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.
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.
18. Köse Çinar, R Dinesen Østergaard, S (2017) Validation of the semi-structured Psychotic Depression Assessment Scale (PDAS) interview. Acta Neuropsychiatr 16.
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.
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.
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.
22. Kadouri, A, Corruble, E Falissard, B (2007) The improved Clinical Global Impression Scale (iCGI): development and validation in depression. BMC Psychiatry 7, 7.
23. Bech, P (2012) Clinical psychometrics. Oxford: John Wiley & Sons.
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.
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.
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.
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.
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.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Acta Neuropsychiatrica
  • ISSN: 0924-2708
  • EISSN: 1601-5215
  • URL: /core/journals/acta-neuropsychiatrica
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed