A psychometric evaluation of the clinician‐rated Quick Inventory of Depressive Symptomatology (QIDS‐C16) in patients with bipolar disorder

The clinician‐rated, 16‐item Quick Inventory of Depressive Symptomatology (QIDS‐C₁₆) has been extensively evaluated in patients with major depressive disorder (MDD). This report assesses the psychometric properties of the QIDS‐C₁₆ in outpatients with bipolar disorder (BD, N = 405) and MDD (N = 547) and in bipolar patients in the depressed phase only (BD‐D) (N = 99) enrolled in the Texas Medication Algorithm Project (TMAP) using classical test theory (CTT) and the Samejima graded item response theory (IRT) model. Values of coefficient alpha were very similar in BD, MDD, and BD‐D groups at baseline (α = 0.80–0.81) and at exit (α = 0.82–0.85). The QIDS‐C₁₆ was unidimensional for all three groups. MDD and BD‐D patients (n = 99) had comparable symptom levels. The BD‐D patients (n = 99) had the most, and bipolar patients in the manic phase had the least depressive symptoms at baseline. IRT analyses indicated that the QIDS‐C₁₆ was most sensitive to the measurement of depression for both MDD patients and for BD‐D patients in the average range. The QIDS‐C₁₆ is suitable for use with patients with BD and can be used as an outcome measure in trials enrolling both BD and MDD patients. Copyright © 2009 John Wiley & Sons, Ltd.     

Psychometric properties of the Quick Inventory of Depressive Symptomatology in adolescents

Objective: The clinician‐rated (QIDS‐C₁₆) and self‐report (QIDS‐SR₁₆) versions of the 16‐item Quick Inventory of Depressive Symptomatology have been extensively examined in adult populations. This study evaluated both versions of the QIDS and the 17‐item Children's Depressive Rating Scale – Revised (CDRS‐R) in an adolescent outpatient sample. Method: Both the QIDS‐C₁₆ and QIDS‐SR₁₆ were completed for the adolescents. Three different methods were used to complete the QIDS‐C₁₆: (a) adolescents' responses to clinician interviews; (b) parents' responses to clinician interview; and (c) a composite score using the most pathological response from the two interviews. Both classical and item response theory methods were used. Factor analyses evaluated the dimensionality of each scale. Results: The sample included 140 adolescent outpatients. All versions of the QIDS, save the parent interview, and the CDRS‐R were very reliable (α ≥ 0.8). All four versions of the QIDS are reasonably effective and unidimensional. The CDRS‐R was clearly at least two‐dimensional. The CDRS‐R was the most discriminating among low and extremely high levels of depression. The QIDS‐SR₁₆ was the most discriminating at moderate levels of depression. There was no relation between the QIDS scores and concurrent Axis III comorbidities. Conclusion: The QIDS‐C₁₆ and the QIDS‐SR₁₆ are suitable for use in adolescents. Copyright © 2010 John Wiley & Sons, Ltd.     

Psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology: A systematic review and meta-analysis

Effective management of depression is predicated upon reliable assessment. The Quick Inventory of Depressive Symptomatology (QIDS) is a depression severity scale with both self-rated (QIDS-SR₁₆) and clinician-rated (QIDS-C₁₆) versions. Although widely used in research, the psychometric properties of the QIDS₁₆ have not been systematically reviewed. We performed a systematic review of studies of the psychometric properties (factor structure, internal consistency, convergent validity, discriminant validity, test-retest reliability and responsiveness to change) of the QIDS-SR₁₆ or QIDS-C₁₆. Six databases were searched: MEDLINE, EMBASE, PsycINFO, CinAHL, Web of Science and the Cochrane Central Register of Controlled Trials. Findings were summarised, bias assessed and correlations with reference standards were pooled. 37 studies (17,118 participants) were included in the review. Both versions of the QIDS₁₆ were unidimensional. Cronbach's alpha ranged from 0.69 to 0.89 for the QIDS-SR₁₆ and 0.65 to 0.87 for the QIDS-C₁₆. The QIDS-SR₁₆ correlated moderately to highly with several depression severity scales. Seven studies were pooled where QIDS-SR₁₆ was correlated with the HRSD-17 (r = 0.76, CI 0.69, 0.81) in patients diagnosed with depression. Four studies examined convergent validity with the QIDS-C₁₆. Four studies examined discriminant validity, for the QIDS-SR₁₆ alone. Eighteen studies had at least one author who was a co-author of the original QIDS₁₆ study. Most studies were conducted in the USA (n = 26). The QIDS-SR₁₆ and the QIDS-C₁₆ are unidimensional rating scales with acceptable internal consistency. To justify the use of the QIDS₁₆ scale in clinical practice, more research is needed on convergent and discriminant validity, and in populations outside the USA.     

抑郁症状快速评定量表自评版(QIDS-SR)应用于HBV相关肝脏疾病患者的心理测量学特性

背景:乙型肝炎病毒(HBV)感染伴发抑郁症是一种常见的现象.建立精确并且有时效的工具,用以评估HBV患者抑郁症状,对研究和临床实践是非常重要的.目的:这项研究测试了抑郁症状快速评定量表自评版(QIDS-SR)在乙型肝炎患者中使用的心理测量学特性.方法:这项研究招募了245名患有乙型肝炎病毒和相关肝病的抑郁症患者.采用蒙特玛莉抑郁评定量表(MADRS)和QIDS-SR评估抑郁症状的严重程度.结果:QIDS-SR的内部一致性((Cronbachα)为0.796.其总分与MADRS总分显著相关r=0.698,p<0.001).探索性因素分析的QIDS-SR显示一维测量性能结论:QIDS-SR(中文版)在乙型肝炎患者中有良好的心理测量学特性,并且在评估临床抑郁症方面是有用的.     

An evaluation of the quick inventory of depressive symptomatology and the hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report.

BACKGROUND: Nine DSM-IV-TR criterion symptom domains are evaluated to diagnose major depressive disorder (MDD). The Quick Inventory of Depressive Symptomatology (QIDS) provides an efficient assessment of these domains and is available as a clinician rating (QIDS-C16), a self-report (QIDS-SR16), and in an automated, interactive voice response (IVR) (QIDS-IVR16) telephone system. This report compares the performance of these three versions of the QIDS and the 17-item Hamilton Rating Scale for Depression (HRSD17). METHODS: Data were acquired at baseline and exit from the first treatment step (citalopram) in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Outpatients with nonpsychotic MDD who completed all four ratings within +/-2 days were identified from the first 1500 STAR*D subjects. Both item response theory and classical test theory analyses were conducted. RESULTS: The three methods for obtaining QIDS data produced consistent findings regarding relationships between the nine symptom domains and overall depression, demonstrating interchangeability among the three methods. The HRSD17, while generally satisfactory, rarely utilized the full range of item scores, and evidence suggested multidimensional measurement properties. CONCLUSIONS: In nonpsychotic MDD outpatients without overt cognitive impairment, clinician assessment of depression severity using either the QIDS-C16 or HRSD17 may be successfully replaced by either the self-report or IVR version of the QIDS.     

Diagnostic utility of the Quick Inventory of Depressive Symptomatology (QIDS‐C16 and QIDS‐SR16) in the elderly

Doraiswamy PM, Bernstein IH, Rush AJ, Kyutoku Y, Carmody TJ, Macleod L, Venkatraman S, Burks M, Stegman D, Witte B, Trivedi MH. Diagnostic utility of the Quick Inventory of Depressive Symptomatology (QIDS‐C₁₆ and QIDS‐SR₁₆) in the elderly. Objective: To evaluate psychometric properties and comparability ability of the Montgomery‐Åsberg Depression Rating Scale (MADRS) vs. the Quick Inventory of Depressive Symptomatology–Clinician‐rated (QIDS‐C₁₆) and Self‐report (QIDS‐SR₁₆) scales to detect a current major depressive episode in the elderly. Method: Community and clinic subjects (age ≥60 years) were administered the Mini‐International Neuropsychiatric Interview (MINI) for DSM‐IV and three depression scales randomly. Statistics included classical test and Samejima item response theories, factor analyzes, and receiver operating characteristic methods. Results: In 229 elderly patients (mean age = 73 years, 39% male, 54% current depression), all three scales were unidimensional and with nearly equal Cronbach α reliability (0.85–0.89). Each scale discriminated persons with major depression from the non‐depressed, but the QIDS‐C₁₆ was slightly more accurate. Conclusion: All three tests are valid for detecting geriatric major depression with the QIDS‐C₁₆ being slightly better. Self‐rated QIDS‐SR₁₆ is recommended as a screening tool as it is least expensive and least time consuming.     

Sensitivity to changes during antidepressant treatment: a comparison of unidimensional subscales of the Inventory of Depressive Symptomatology (IDS-C) and the Hamilton Depression Rating Scale (HAMD) in patients with mild major, minor or subsyndromal depression

In the efficacy evaluation of antidepressant treatments, the total score of the Hamilton Depression Rating Scale (HAMD) is still regarded as the 'gold standard'. We previously had shown that the Inventory of Depressive Symptomatology (IDS) was more sensitive to detect depressive symptom changes than the HAMD17 (Helmreich et al. 2011). Furthermore, studies suggest that the unidimensional subscales of the HAMD, which capture the core depressive symptoms, outperform the full HAMD regarding the detection of antidepressant treatment effects. The aim of the present study was to compare several unidimensional subscales of the HAMD and the IDS regarding their sensitivity to changes in depression symptoms in a sample of patients with mild major, minor or subsyndromal depression (MIND). Biweekly IDS-C28 and HAMD17 data from 287 patients of a 10-week randomised, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural group therapy in patients with MIND were converted to subscale scores and analysed during the antidepressant treatment course. We investigated sensitivity to depressive change for all scales from assessment-to-assessment, in relation to depression severity level and placebo-verum differences. The subscales performed similarly during the treatment course, with slight advantages for some subscales in detecting treatment effects depending on the treatment modality and on the items included. Most changes in depressive symptomatology were detected by the IDS short scale, but regarding the effect sizes, it performed worse than most subscales. Unidimensional subscales are a time- and cost-saving option in judging drug therapy outcomes, especially in antidepressant treatment efficacy studies. However, subscales do not cover all facets of depression (e.g. atypical symptoms, sleep disturbances), which might be important for comprehensively understanding the nature of the disease depression. Therefore, the cost-to-benefit ratio must be carefully assessed in the decision for using unidimensional subscales.