The Reynolds Adolescent Depression Scale in New Zealand adolescents

OBJECTIVE: To examine aspects of the reliability and validity of the Reynolds Adolescent Depression Scale (RADS) in measuring depression in New Zealand adolescents of all major ethnic groups. METHOD: A sample of 9699 randomly selected New Zealand secondary school students participated in the Youth2000 Health and Wellbeing Survey which included the RADS. Data from this survey have been used to assess some aspects of the reliability and validity of the RADS in the New Zealand context across different ethnic groups. Cronbach's alpha, item-total score correlations, correlation to other questions and a factor analysis were done in order to examine the internal reliability, content validity, convergent validity and construct validity of the data and compare to the original Reynolds validation study. RESULTS: Tests of the scale resulted in scores over 0.90 on Cronbach's alpha and high item-total score correlations, with a median correlation of 0.62 and 25 of the 30 correlations measuring more than 0.5. The scores were found to have similar factor structure to the original scale and the correlations to other depression related questions indicate acceptable concurrent validity. CONCLUSIONS: On all of the tests conducted, the RADS was found to have acceptable reliability and validity for New Zealand adolescents across the major different ethnic groups, indicating that it is a valid and appropriate instrument to use with New Zealand adolescents.     

Use of the Hamilton Rating Scale for Depression and the Carroll Self-Rating Scale in adolescents

The relationship of clinicians' ratings of depression in adolescents to self-rating is important to clinical research. The Hamilton Rating Scale for Depression (HRSD) and the Carroll Self-Rating Scale (CSRS) were compared in a study of 81 psychiatrically hospitalized adolescents. The correlation of CSRS and HRSD total scores in adolescents with melancholic major depression was 0.46, lower than the correlation reported in adults (0.80). Higher correlations were seen in females and in nonmelancholic and nondepressed subgroups. While the comparison of the two rating methods suggests some characteristics of depressed adolescents' presentation of their illness, it does not appear that the self-rating instrument can be used as an alternative to clinicians' ratings.     

The Hamilton Depression Scale

The consistency of the Hamilton Depression Scale (HDS) as a measure of the severity of depressive states has been examined when the scale was used weekly during a trial with imipramine. By use of logistic models (Rasch) the consistency of the HDS has been considered across patient-variables as age, sex, plasma levels of imipramine, and diagnosis. The results showed that the original 17-item HDS was without adequate consistency, i.e. the total score of the sample of items was no one-dimensional measure of depressive states. However, a melancholia subscale of the HDS contained items the total of which can be used to compare patients quantitatively, although in some part of the analysis one of these items showed ceiling effect. It was concluded that the melancholia sub-scale (containing the items depressed mood, guilt, work and interests, retardation, psychic anxiety, and general somatic symptoms) can form the basis for further improvements in the field of quantitative rating scales for depressive states.     

Factor structure of the Center for Epidemiologic Studies Depression Scale in Taiwanese adolescents

BackgroundThe original study of Radloff (Appl Psychol Meas. 1977. 1:385-401) on the Center for Epidemiologic Studies Depression Scale (CES-D) indicated a 4-factor model in the adult population. However, the factor structure of the CES-D in Asian adolescents has not been extensively validated. The aim of this study was to examine the factor structure of the Chinese version of the CES-D in a large representative Taiwanese adolescent population.MethodA total of 10 116 adolescents completed the Chinese version of the CES-D. We used confirmatory factor analysis to examine the adequacy of 5 models of the factor structure in adolescents who were divided into 4 groups by sex and age. We also enrolled the variables of suicide tendency, insomnia, and peer relationships into the confirmatory factor analysis to examine the factor structure of the CES-D and examined the correlations between the CES-D factors and these variables.ResultsThe results of this study indicated that the four-factor model (depressed affect, somatic symptoms, interpersonal problems, and positive affect) had the highest validity in Taiwanese adolescents. We also found that although the 4 factors of the CES-D were correlated with each other, their correlations with suicide tendency, insomnia, and peer relationships were different.ConclusionsThis study supported the usefulness of the Chinese version of the CES-D as a tool to understand the concept of depression in Taiwanese adolescents.     

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of > or =6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values > or =9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.     

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of ≥6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values ≥9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.     

The Bech-Rafaelsen Mania Scale and the Hamilton Depression Scale.

In a study of 18 patients with manic symptomatology and 31 patients with melancholic symptomatology the Bech-Rafaelsen Mania Scale (BRMS) and the Hamilton Depression Scale (HDS) have been compared. The results showed that the inter-observer reliability of the BRMS was adequate compared with the HDS. Both scales are constructed for assessing the severity of manic or melancholic states, and no difference was found in the total BRMS or HDS score between the various diagnostic groups, when the patients were classified by an index of the course and symptomatology otive disorder, using the Multi-axial Classificetion System for Affective Disorders (MULTI-CLAD). The homogeneity of the BRMS seemed more adequate than that of the HDS, when each item was correlated to the corresponding total score. Although the homogeneity of the BRMS needs to be evaluated by other statistical models than correlation analysis, our results seem to indicate that the improvement in assessing manic-melancholic states quantitatively is a matter of redefining items or incorporating new items in the melancholic rather than the manic part of these rating scales.     

Assessment of depressive symptoms in Japanese school children and adolescents using the Birleson Depression Self-Rating Scale

OBJECTIVE: The aim of this study was to investigate the prevalence of depressive symptoms in children and adolescents in the general Japanese population using a depression self-rating scale and determine whether this prevalence varies according to age, gender, or region. METHOD: The Birleson Depression Self-Rating Scale for children (DSRS) was used to examine the extent to which depressive tendencies were present among 2,453 elementary and middle-school children (6 to 15 years old) in two cities in Japan. RESULTS: The mean DSRS score was high at 8.75 +/- 5.66. A significant increase in score was observed with increasing age. There were no significant differences between regions. Using a DSRS cutoff score of 15 points as a risk of depression, the scores of 14.9% of the subjects exceeded the cutoff. CONCLUSIONS: As determined using the DSRS, a high proportion of Japanese children and adolescents have depressive tendencies.     

Hamilton Depression Scale in dementia

INTRODUCTION : Wide variations in frequency of depression in primary degenerative dementia (PDD) and in vascular dementia (VD) have been reported. This may perhaps be due to inadequacy of common diagnostic tools in detecting depression in the face of cognitive decline. We evaluated here the Hamilton Depression Rating Scale (HDRS) in demented patients with PDD and VD. METHODS : We examined 50 consecutive patients with PDD and 50 consecutive patients with VD. All patients underwent neurological examination and their depression was evaluated using DSM-III-R criteria and the HDRS. The data obtained were analysed for distribution of depression and pattern of responses obtained in the HDRS. Sensitivity, specificity and Youden's J-indices for different cut-off scores of the HDRS in its ability to detect depression in this population were calculated. RESULTS : Dementia was associated with depression in 38% of the patients (DSM-III-R criteria). HDRS scores were higher in depressed patients (z= -5.7, P < 0.0001) with an HDRS cut-off score of 10 being indicative of depression in demented patients. Symptoms related to 'affective' components of the HDRS (such as depressive mood and anxiety) were strongly associated with the diagnosis of depression (Mann-Whitney tests, P < 0.0001). CONCLUSION : Depression is frequent in demented patients. The HDRS has good criterion validity in the evaluation of depression in demented patients. (Int J Psych Clin Pract 2002; 6: 91-94)     

Depression in children and adolescents

Depression is a common problem in children and adolescents. The disorder may be overlooked because of the prominent irritability seen in children with depression and because of the perception that moodiness is a normal phase of childhood. Depression frequently is associated with other psychiatric problems and neurologic disorders. Therapy consists of psychotherapy and medication, with SSRIs the first choice for pharmacotherapy.     

爱丁堡产后抑郁量表的临床应用

目的:初步探讨Edinburgh产后抑郁量表（EPDS）用于中国妇女的临床用．量表性能及适宜的分界值。方法：298名产妇在产后第三天用EPDS、BDI、GHQ进行评定,抽取部分产妇用DSM－Ⅲ－R临床试验式检查－住院版（SCID－NP）进行调查,以建立DSM－Ⅲ－R抑郁障碍的诊断。结果：EPDS和BDI、GHQ具有良好的平行效度。以BDI量表分和DSM－Ⅲ－R诊断结果为标准,其临床筛查分界值应为9／10。结论：EPDS具有良好的临床使用性能,是筛查产后抑郁简便而敏感的量表,推荐其分界值为9／10。     

The responsiveness of the Hamilton Depression Rating Scale

In clinical studies of antidepressants, the Hamilton Depression Rating Scale (HAMD) total score has been the gold standard instrument for establishing and comparing the efficacy of new treatments. However, the HAMD is a multidimensional measure, which may reduce its ability to detect differences between treatments, in particular, changes in core symptoms of depression. Two meta-analyses were conducted to compare the responsiveness of the HAMD total score with several published unidimensional subscale scores based upon core symptoms of depression. The first compared the above instrument's ability to detect differences between fluoxetine and placebo across eight studies involving over 1600 patients. The second analysis involved four studies and over 1200 patients randomized to tricyclic antidepressants and placebo. In both meta-analyses, the unidimensional core subscales outperformed the HAMD total score at detecting treatment differences. The implications of this on sample sizes and power for clinical studies will be discussed. In fact, studies based on the observed effect sizes from the core subscales would require approximately one-third less patients than studies based on the HAMD total score. Effect sizes from each individual HAMD item will also be presented to help explain the differences in responsiveness between the scales.     

The Hamilton Depression Rating Scale in normals and depressives

The Hamilton Rating Scale for depression (HDRS) has become the standard observer rating scale for depression, yet there are no adequate data from normal samples. The present study was carried out in northern Italy. The purposes were 1) to examine the ratings in normals and 2) to examine the scale's validity in a different language and culture. The scale was used in 40 normals and 40 depressives who were matched. Two self-rating scales of depression were administered: the Symptom Rating Test and the Symptom Questionnaire. The results show that the HDRS is a valid mea- sure in that it sensitively discriminates between depressed patients and normals. The findings support Hamilton's view that only the first 17 items of the scale are appropriate for computing the score. The use of self-rating scales yielded additional information. The misclassification rate of the Symptom Rating Test was similar to that of the HDRS. The combined use of Research Diagnostic Criteria (RDC) and HDRS appears to be more reliable for the selection of depressed patients for research than the RDC only.     

非语言性抑郁量表在卒中后失语患者抑郁识别中的作用

约有1/3的卒中患者存在失语症状。语言交流的障碍严重影响了卒中后失语患者的工作、学习、日常生活和社交活动,使其成为抑郁的高发人群。临床常用的抑郁评定方法多存在语言依赖性,不适合于语言障碍的患者,使卒中后失语患者的抑郁情绪常常被忽略。为了解决这一问题,有学者开发了一些非语言依赖性的抑郁评定量表。本文对这些非语言性抑郁量表在临床上的应用情况作一综述。     

The Center for Epidemiologic Studies Depression Scale: factor validity and reliability in a French sample of adolescents with Intellectual Disability

The purpose of this study was to test the factor validity and reliability of the Center for Epidemiologic Studies Depression Scale (CES-D) within a sample of adolescents with mild to moderate Intellectual Disability (ID). A total sample of 189 adolescents (121 boys and 68 girls), aged between 12 and 18 years old, with mild to moderate ID were involved in two studies. In study 1, the content, phrasing and answering format of the CES-D were adapted for adolescents with ID. This instrument was renamed CES-D for ID (CES-D-ID) and two different versions based on two alternative answer scales (Likert and Likert-graphical) were developed and their psychometric properties were verified in study 2. The results provided support for the factor validity, reliability and invariance across gender and age of a 14-item version of the CES-D-ID based on a Likert-graphical answer scale.     

The Montgomery-Asberg Depression Scale: reliability and validity

The Montgomery-Asberg Depression Scale was evaluated in 44 depressed inpatients. All items of the scale occurred frequently in the sample; the scale exhibited construct validity (internal homogeneity) and concurrent validity relative to the Hamilton Depression Scale and the concepts of endogenous and nonendogenous depression. Sleep disturbance, reduced appetite, and suicidal thoughts, correlated poorly with the remainder of the scale. Reasons for this finding are discussed. Inter-rater reliability was demonstrated between a psychiatrist and a nurse on individual item and total scale scores.     

Factor structure of the CES-D (Center for Epidemiologic Studies Depression Scale) among Filipino-American adolescents

The present study used factor analytic procedures to examine the factor structure of the CES-D among Filipino-American adolescents residing in rural and small town Hawaii. A total of 243 Filipino-American high school students completed the 20-item scale, and maximum likelihood analyses were employed to obtain a final solution. The results indicated that two factors provide a reasonably good fit: factor I combined depressed affect, somatic-retardation and interpersonal items, and factor II consisted of the remaining four positive affect items. The overlap of depressed affect and somatic symptoms support previous findings found among Asian American adults and other ethnic minority adolescents. The loading of the interpersonal items on the first factor is more unusual and suggests that interpersonal factors are not distinguished from depressed affect for the Filipino-American adolescent group. The usefulness of the CES-D as a tool to gain an understanding of the concept of depression across cultures is discussed. Accepted: 3 December 1998