Skip to main content
×
Home
    • Aa
    • Aa

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

  • R. Uher (a1), A. Farmer (a1), W. Maier (a2), M. Rietschel (a3), J. Hauser (a4), A. Marusic (a5), O. Mors (a6), A. Elkin (a1), R. J. Williamson (a1), C. Schmael (a3), N. Henigsberg (a7), J. Perez (a8), J. Mendlewicz (a9), J. G. E. Janzing (a10), A. Zobel (a2), M. Skibinska (a4), D. Kozel (a5), A. S. Stamp (a6), M. Bajs (a7), A. Placentino (a8), M. Barreto (a9), P. McGuffin (a1) and K. J. Aitchison (a1) (a11)...
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.

Copyright
Corresponding author
*Address for correspondence: R. Uher, PO80 SGDP, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK. (Email: r.uher@iop.kcl.ac.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

RM Bagby , AG Ryder , DR Schuller , MB Marshall (2004). The Hamilton Depression Rating Scale: has the gold standard become a lead weight? American Journal of Psychiatry 161, 21632177.

P Bech , P Cialdella , MC Haugh , MA Birkett , A Hours , JP Boissel , GD Tollefson (2000). Meta-analysis of randomised controlled trials of fluoxetine v. placebo and tricyclic antidepressants in the short-term treatment of major depression. British Journal of Psychiatry 176, 421428.

P Bech , LF Gram , E Dein , O Jacobsen , J Vitger , TG Bolwig (1975). Quantitative rating of depressive states. Acta Psychiatrica Scandinavica 51, 161170.

AT Beck , CH Ward , M Mendelson , J Mock , J Erbaugh (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.

TA Brown (2006). Confirmatory Factor Analysis for Applied Research. Guilford Press: New York.

C Browne , HC Schulberg , MJ Madonia (1995). Assessing depression in primary care practice with the Beck Depression Inventory and Hamilton Rating Scale for Depression. Psychological Assessment 7, 5965.

TJ Carmody , AJ Rush , I Bernstein , D Warden , S Brannan , D Burnham , A Woo , MH Trivedi (2006). The Montgomery Asberg and the Hamilton ratings of depression: a comparison of measures. European Neuropsychopharmacology 16, 601611.

BC Edwards , MJ Lambert , PW Moran , T McCully , KC Smith , AG Ellingson (1984). A meta-analytic comparison of the Beck Depression Inventory and the Hamilton Rating Scale for Depression as measures of treatment outcome. British Journal of Clinical Psychology 23, 9399.

I Elkin , MT Shea , JT Watkins , SD Imber , SM Sotsky , JF Collins , DR Glass , PA Pilkonis , WR Leber , JP Docherty (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. Archives of General Psychiatry 46, 971982.

KR Evans , T Sills , DJ DeBrota , S Gelwicks , N Engelhardt , D Santor (2004). An item response analysis of the Hamilton Depression Rating Scale using shared data from two pharmaceutical companies. Journal of Psychiatric Research 38, 275284.

D Faries , J Herrera , J Rayamajhi , D DeBrota , M Demitrac , WZ Potter (2000). The responsiveness of the Hamilton Depression Rating Scale. Journal of Psychiatric Research 34, 310.

M Feinberg , BJ Carroll , PE Smouse , SG Rawson (1981). The Carroll rating scale for depression. III. Comparison with other rating instruments. British Journal of Psychiatry 138, 205209.

DB Flora , PJ Curran (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods 9, 466491.

FJ Floyd , KF Widaman (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment 7, 286299.

RD Gibbons , DC Clark , DJ Kupfer (1993). Exactly what does the Hamilton Depression Rating Scale measure? Journal of Psychiatric Research 27, 259273.

RP Greenberg , RF Bernstein , MD Greenberg , S Fisher (1992). A meta-analysis of antidepressant outcome under ‘blinder’ conditions. Journal of Consulting and Clinical Psychology 60, 664669.

CM Gullion , AJ Rush (1998). Toward a generalizable model of symptoms in major depressive disorder. Biological Psychiatry 44, 959972.

M Hamilton (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.

M Hamilton (1967). Development of a rating scale for primary depressive illness. British Journal of Clinical Psychology 6, 278296.

LG Humphreys , RG Montanelli (1975). An investigation of the parallel analysis criterion for determining the number of common factors. Multivariate Behavioral Research 10, 193206.

A Korszun , V Moskvina , S Brewster , N Craddock , F Ferrero , M Gill , IR Jones , LA Jones , W Maier , O Mors , MJ Owen , M Preisig , T Reich , M Rietschel , A Farmer , P McGuffin (2004). Familiality of symptom dimensions in depression. Archives of General Psychiatry 61, 468474.

HJ Moller (2001). Methodological aspects in the assessment of severity of depression by the Hamilton Depression Scale. European Archives of Psychiatry and Clinical Neuroscience 251 (Suppl. 2), II13II20.

SA Montgomery , M Asberg (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382389.

M Orlando , CD Sherbourne , D Thissen (2000). Summed-score linking using item response theory: application to depression measurement. Psychological Assessment 12, 354359.

BA Prusoff , GL Klerman , ES Paykel (1972). Concordance between clinical assessments and patients' self-report in depression. Archives of General Psychiatry 26, 546552.

LP Rehm , MW O'Hara (1985). Item characteristics of the Hamilton Rating Scale for Depression. Journal of Psychiatric Research 19, 3141.

HG Ruhe , JJ Dekker , J Peen , R Holman , F de Jonghe (2005). Clinical use of the Hamilton Depression Rating Scale: is increased efficiency possible? A post hoc comparison of Hamilton Depression Rating Scale, Maier and Bech subscales, Clinical Global Impression, and Symptom Checklist-90 scores. Comprehensive Psychiatry 46, 417427.

AJ Rush , MH Trivedi , TJ Carmody , HM Ibrahim , JC Markowitz , GI Keitner , SG Kornstein , B Arnow , DN Klein , R Manber , DL Dunner , AJ Gelenberg , JH Kocsis , CB Nemeroff , J Fawcett , ME Thase , JM Russell , DN Jody , FE Borian , MB Keller (2005). Self-reported depressive symptom measures: sensitivity to detecting change in a randomized, controlled trial of chronically depressed, nonpsychotic outpatients. Neuropsychopharmacology 30, 405416.

DA Santor , JC Coyne (2001). Examining symptom expression as a function of symptom severity: item performance on the Hamilton Rating Scale for Depression. Psychological Assessment 13, 127139.

AB Shafer (2006). Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung. Journal of Clinical Psychology 62, 123146.

Recommend this journal

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

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: