Study of the concurrent validity of the Calgary Depression Scale for Schizophrenics (CDSS)

The aim of this study was to investigate the concurrent validity of the French language version of the Calgary Depression Scale for Schizophrenics (CDSS). Ninety-five schizophrenic patients meeting the DSM-III-R criteria were enrolled in the study. The depressive symptoms were evaluated using the Calgary Depression Scale for Schizophrenics (CDSS), Hamilton Depression Rating Scale (HDRS), Montgomery and Asberg Rating Scale (MADRS), and Widlocher Psychomotor Retardation Scale (ERD). The psychotic symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) and the extrapyramidal symptoms with the Extrapyramidal Syndrome Rating Scale (ESRS). The CDDS was significantly correlated with all the conventional depression-rating scales. We only found significant positive correlations between the CDSS and the PANSS-positive sub-scale. The CDSS total score was significantly correlated with some PANSS-positive items (delusions and hallucinatory behaviour). No significant correlation between the depression-rating scales and the PANSS-negative sub-scale was observed. For all the depression-rating scales, no correlation with the extrapyramidal symptom was evidenced. The results confirmed the validity of the CDSS in the evaluation of depression in schizophrenia. The relationship between depression and the positive symptoms of schizophrenia is discussed.     

The Calgary Depression Rating Scale for schizophrenia in a healthy control group: psychometric properties and reference values

BACKGROUND: Assessment of depression in schizophrenia is of great importance as depressive signs and symptoms and suicidality are highly prevalent in patients with schizophrenic disorders. The Calgary Depression Rating Scale (CDSS) is the standard assessment instrument for that purpose due to its proven reliability and validity. However, so far no reference values derived from an adequate healthy sample have been published. METHODS: The present study analyzed CDSS item scores and summary scores in 154 healthy subjects (49% female, mean age 32.8+/-11.7 years) selected from studies as controls for schizophrenic patients. RESULTS: The total CDSS score was 2.6+/-2.7 (range 0-12), about 1/3 of healthy subjects had scores=0. Gender differences were observed with respect to "early awakening" and "suicidal ideation" with higher scores in females. Total CDSS scores (r=-0.17, P=0.03) and single items were slightly negatively correlated with age. The psychometric properties of the CDSS scale were satisfying (corrected item-score correlations r(tc)=0.33-0.61, internal consistency Cronbach's alpha=0.76, one-dimensional factor structure). CDSS total scores showed a skewed distribution fitting the upper part of a normal distribution. Based on the empirical distribution of CDSS values, reference values were listed for the total group of healthy subjects, and for females and males separately. CONCLUSIONS: The results corroborate the favourable psychometric properties of the CDSS found previously in clinical samples in a healthy control group. The reference values reported here can assist the clinical use and interpretation of CDSS values and emphasize the usefulness of the CDSS for a thorough assessment of depression and suicidality in schizophrenia.     

Do Somatic Symptoms Predict the Severity of Depression? A Validation Study of the Korean Version of the Depression and Somatic Symptoms Scale

This study aimed at exploring the psychometric characteristics of the Korean Version of the Depression and Somatic Symptoms Scale (DSSS) in a clinical sample, and investigating the impact of somatic symptoms on the severity of depression. Participants were 203 consecutive outpatients with current major depressive disorders (MDD) or lifetime diagnosis of MDD. The DSSS was compared with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the 17-items Hamilton Depression Rating Scale (HAMD). The DSSS showed a two-factor structure that accounted for 56.8% of the variance, as well as excellent internal consistency (Cronbach’s alpha = 0.95), concurrent validity (r = 0.44–0.82), and temporal stability (intraclass correlation coefficient = 0.79). The DSSS had a high ability to identify patients in non-remission (area under receiver operating characteristic [ROC] curve = 0.887). Maximal discrimination between remission and non-full remission was obtained at a cut-off score of 22 (sensitivity = 82.1%, specificity = 81.4%). The number of somatic symptoms (the range of somatic symptoms) and the scores on the somatic subscale (SS, the severity of somatic symptoms) in non-remission patients were greater than those in remission patients. The number of somatic symptoms (slope = 0.148) and the SS score (slope = 0.472) were confirmed as excellent predictors of the depression severity as indicated by the MADRS scores. The findings indicate that the DSSS is a useful tool for simultaneously, rapidly, and accurately measuring depression and somatic symptoms in clinical practice settings and in consultation fields.     

A psychometric analysis of the Clinically Useful Depression Outcome Scale (CUDOS) in Spanish patients

Background

Psychometrically sound and time-efficient scales that measure depressive symptoms are essential for research and clinical practice. This study was aimed at exploring the psychometric properties of the Spanish version of the Clinically Useful Depression Outcome Scale (CUDOS) in a clinical sample.

Method

Participants were 162 patients (72% women) with a mood disorder (86% diagnosed as major depressive disorder). Depressive symptoms were assessed by means of the CUDOS, the Beck Depression Inventory (BDI), and two interviewer-rated instruments: the 17-item Hamilton Depression Rating Scale (HDRS₁₇) and the Clinical Global Impression-Severity (CGI-S) scale. Dimensionality, internal consistency, test–retest reliability, construct validity, criterion validity, and responsiveness to change of the CUDOS were explored.

Results

The CUDOS exhibited a one-factor structure which accounted for 55.7% of the variance, and excellent results for internal consistency (Cronbach's alpha=0.93), for test–retest reliability (intraclass correlation coefficient=0.84) and for convergent validity [HDRS₁₇ (r=0.77), CGI-S (r=0.73) and BDI (r=0.89)]. The ability of the CUDOS to identify patients in remission was high (area under ROC curve=0.96). Its responsiveness to change was also highly satisfactory: patients with greater clinical improvement showed a greater decrease in CUDOS scores (p<0.001).

Limitations

Diagnoses, even though made by expert clinicians, were established as part of routine clinical practice. Generalizability of the findings beyond the study sample is unknown.

Conclusions

The findings suggest that the Spanish version of the CUDOS is valuable as a brief and psychometrically sound self-report instrument to assess depressive symptoms in research and in clinical practice.     

Rating dysthymia: an assessment of the construct and content validity of the Cornell Dysthymia Rating Scale

BACKGROUND: Mason et al. developed the Cornell Dysthymia Rating Scale (CDRS), a 20-item clinician-rated inventory, and hypothesized that it may be superior to the commonly-used Hamilton Depression Rating Scale (HDRS) in assessing the symptoms of dysthymia, a form of chronic depression. The purpose of this study was to compare these instruments in an outpatient sample of dysthymic patients. METHOD: The CDRS and the HDRS and other inventories (including the Hopkins Symptom Check List (SCL)) were administered to 110 patients meeting DSM-IIIR diagnosis of dysthymia. RESULTS: There was a significant correlation between the CDRS and the HDRS at baseline and termination, indicating concurrent validity. Distributional statistics were compared for baseline and termination severity scores, showing that the CDRS has greater severity range scores than the HDRS. Furthermore, results of the DSM-IV Mood Disorders Field Trial suggest that the CDRS has better content validity than the HDRS when it comes to the dysthymic population. LIMITATIONS: The results are limited by the use of a homogeneous sample, the absence of observer ratings of divergent symptoms, and less than excellent validity of self-report divergent symptoms. CONCLUSIONS: Our results support the value of the CDRS in assessing symptoms of dysthymia.     

Association of biomarkers and depressive symptoms in schizophrenia

Emergence of depressive symptoms in schizophrenia results in a deteriorating course and poor prognosis. Schizophrenia and depressive disorder are both associated with low levels of brain-derived neurotrophic factor (BDNF) and with a longstanding low grade inflammatory state. The objective of this study is to analyze the relationship between these serum biomarkers and depressive and psychotic symptoms in schizophrenic patients. Thirty-nine individuals diagnosed with schizophrenia or schizoaffective disorder by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), assessed by Structured Clinical Interview for DSM-IV (SCID), were included. Interviews were conducted with The Positive and Negative Syndrome Scale (PANSS) and The Calgary Depression Scale for Schizophrenia (CDSS). Blood samples were collected for determination of BDNF, IL-1beta, IL-6, IL-8, IL-10, IL-12 and TNF-alpha measurements. Positive correlations between BDNF and CDSS and between IL-1beta and severity in PANSS scores were found. BDNF levels were not correlated with any cytokine or with PANSS scores. The results of this study suggest that depressive and psychotic symptoms may be associated with different profiles of biomarkers in the association between schizophrenia and depression.     

Validation of the Korean-Version of the Clinical Assessment Interview for Negative Symptoms of Schizophrenia (CAINS)

The Clinical Assessment Interview for Negative Symptoms (CAINS) was developed to overcome the limitations of existing instruments and reflect the current view of negative symptoms. The aim of the present study was to evaluate the reliability and validity of the Korean version of the Clinical Assessment Interview for Negative Symptoms (K-CAINS). Inpatients (n = 49) and outpatients (n = 70) with schizophrenia were recruited from three institutions. The confirmative factor analysis, test-retest reliability, inter-rater reliability, convergent validity, and discriminant validity were assessed. The study group consisted of 71 males (59.7%) and 48 females (40.3%). Their mean age was 42.15 years (SD = 12.2). The K-CAINS was confirmed to be divided into two subscales of 9 items related to "motivation/pleasure" and 4 items related to "expression" in concordance with the original version of the CAINS. The results showed that the K-CAINS had a good inter-rater reliability (ICC = 0.84-0.94), test-retest reliability (r = 0.90, P < 0.001). Convergent validity was proven by demonstrating a significant correlation with the Positive and Negative Syndrome Scale (PANSS) negative subscale, and the Scale for the Assessment of Negative Symptoms (SANS). Discriminant validity was proven by the lack of a significant correlation with the PANSS positive subscale, the Korean version of the Beck depression inventory (BDI), the Korean version of the Calgary depression scale for schizophrenia (K-CDSS), and the Modified Simpson Angus scale (MSAS). The K-CAINS could be a reliable and valid tool to assess the negative symptoms of Korean schizophrenia patients.     

Validation of the children's depression rating scale- revised for adolescents in primary-care pediatric use in India

Background: Adolescent depression needs to be identified and treated in the primary care settings. There is no clinician-rated measure validated in India for identifying depression among adolescents. Aim: We studied the diagnostic accuracy, reliability, and validity of Children's Depression Rating Scale - Revised (CDRS-R) for primary care pediatrics. Setting and Design: Prospective study in three schools in Southern India. Materials And Methods: Adolescents recruited were administered the CDRS-R by a pediatrician and clinical psychologist along with Beck Depression Inventory (BDI) for convergent validity. Impact of Event Scale (IES) for divergent validity and the ICD-10 clinical diagnosis of depressive disorders using modified Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) interview as reference standard were administered by a psychiatrist independently. Appropriate statistical analyses for diagnostic accuracy, reliability, and validity were done. Results: A cut-off score of 30 (sensitivity = 83%, specificity = 84%; AUC in ROC = 87%) in CDRS-R is suggested for diagnosing depression. The inter-rater reliability (r = 0.73) and test-retest reliability (r = 0.98) was good. In addition to the adequate face and content validity, CDRS-R had good internal consistency (α = 0.76), high convergent (r = 0.71; P = 0.001), and divergent validity (r = 0.28; P = 0.20). There was moderate concordance with the reference standard of ICD-10 diagnosis (45.5%) in identifying depression and CDRS-R discriminated 80% of the other psychiatric morbidity. The six-factor structure explained 60.6% of variance. Conclusion: The CDRS-R showed strong psychometric properties and is now available for use in the primary-care pediatric practice in India.     

Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders

BackgroundDrug-resistant depression is a major therapeutic issue in psychiatry and the development of non-drug therapies that treat drug-resistant depression is required. Sleep deprivation (SD) is a non-drug treatment classified as a form of chronotherapy in addition to bright light therapy (BLT) and sleep phase advance (SPA). Combined chronotherapy is hypothesized to improve drug-resistant depression. In this study, we investigated the benefits of total sleep deprivation (TSD) followed by SPA and BLT in drug-resistant depression alongside ongoing antidepressant medication and observed the added effectiveness of the combined chronotherapy.MethodsThirteen drug-resistant inpatients affected by a major depressive episode were studied. They were treated by TSD followed by SPA (three days) and BLT (five days) with ongoing drug treatment. Effectiveness was rated using the Hamilton Rating Scale for Depression (HAM-D), the Zung Self-Rating Depression Scale (SDS), and the Visual Analogue Scale (VAS) over 3 weeks.ResultsSignificant improvements of depressive symptoms were observed in both objective mood ratings (HAM-D) and subjective mood ratings (SDS and VAS). Eight out of 13 patients maintained this responsiveness (50% or greater changes in HAM-D) across the study period. Moreover, no patients dropped out of the combined chronotherapy procedure.LimitationsThe study did not have a placebo group, and more subjects may be needed.ConclusionThe trial of combined chronotherapy successfully induced rapid improvement in depressive symptoms in drug-resistant patients without early relapse or obvious side effects.     

Validation of a Hamilton subscale for endogenomorphic depression

The current study examined the validity of a subscale for endogenomorphic depression derived from the Hamilton Rating Scale for Depression. In a sample of 147 women outpatients with primary depression, subscale (HES) scores were bimodally distributed around the mean score of 7.38. High-HES patients had significantly elevated scores on measures of depressive symptomatology, generalized symptomatic distress, and social impairment relative to low-HES patients. Classifications based on HES scores significantly predicted RDC and DSM-III subtype diagnoses of endogenous and nonendogenous depression. Diagnostic predictions based on the subscale's items were superior to predictions made using the 'non-endogenomorphic' Hamilton items. Potential applications for research are discussed.     

首发精神分裂症患者抑郁症状9年随访

目的:探讨首发精神分裂症病人接受抗精神病药物治疗后9年中抑郁症状的转归及与其他相关因素的关系。方法:本研究纳入符合中国精神疾病分类方案与诊断标准第二版修订本(CCMD-2-R)精神分裂症诊断标准的164例首次发病住院患者,用汉密尔顿抑郁量表(HAMD)、简明精神病评定量表(BPRS)、阴性症状量表中文版(SANS-CV)、临床总体印象量表(CGI)及功能总体评定量表(GAF)对患者在入院时及治疗后9年中每年进行一次评定,并据此计算缓解时间。结果:共139例患者完成随访。从治疗后的第1年起,每年末HAMD总分≥8分的患者所占比例为3.6%～13.7%,治疗后1～9年的HAM D总分均低于入院水平(P0.001)。入组时HAM D总分与治疗后9年中的缓解时间、9次年末的去除焦虑抑郁因子BPRS总分、SANS-CV、CGI及GAF分均无统计学意义相关。结论:经抗精神病药治疗1年之后,首发精神分裂症患者急性期的抑郁症状迅速减轻,此后在较低水平上略有波动;急性期抑郁症状水平不能预测精神分裂症的长期预后。     

Levels of depressive symptoms in spouses of people with lung cancer: effects of personality, social support, and caregiving burden

The authors sought to identify the personality correlates of depressive symptoms in 120 spouses of people with lung cancer. Spouses completed questionnaires, including measures of personality (neuroticism, extraversion, and interpersonal self-efficacy), social support, and caregiving burden. Their level of depressive symptoms was measured with self-report (Center for Epidemiologic Studies Depression Scale) and interviewer (Hamilton Depression Rating Scale) ratings. Structural equation modeling showed that neuroticism was directly associated with greater depressive symptoms and indirectly associated with less social support and greater caregiving burden. Interpersonal self-efficacy was indirectly associated with the severity of depressive symptoms through both social support and caregiving burden. These findings have implications for identifying spouses of individuals with lung cancer who are vulnerable to depression and could inform the design of programs to reduce depressive symptoms in the context of cancer caregiving.     

The Quick Inventory of Depressive Symptomatology-Self-report: a psychometric evaluation in patients with asthma and major depressive disorder.

BACKGROUND: Despite the high co-occurrence between depression and asthma, few studies have addressed methods assessing the severity of depressive symptoms among patients with asthma. OBJECTIVE: To evaluate the psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-report (QIDS-SR16), a 16-item measure of depressive symptom severity, in patients with asthma. METHODS: The psychometric properties of the QIDS-SR16 were compared at treatment exit with those of the 30-item self-report Inventory of Depressive Symptomatology (IDS-SR30) and the 17-item clinician-rated Hamilton Rating Scale for Depression (HRSD17) in 73 outpatients with asthma who were treated with citalopram or placebo for nonpsychotic major depressive disorder. Correlations between the depression rating scales and the Mini Asthma Quality of Life Questionnaire were calculated. RESULTS: Internal consistency at exit was strong for the QIDS-SR16 (Cronbach alpha values are .87 for the QIDS-SR16, .95 for the IDS-SR30, and .87 for the HRSD17). The QIDS-SR16 and HRSD17 total scores were highly correlated (r = 0.85), as were the QIDS-SR16 and IDS-SR30 total scores (r = 0.97). All QIDS-SR16 item total score correlations were significant (P < .001). The QIDS-SR16, IDS-SR30, and HRSD17 showed comparable sensitivity to symptom change, indicating high concurrent validity for all 3 scales. The total QIDS-SR16 baseline to exit change score demonstrated a significant negative correlation (r = -0.49, P < .001) with the Mini Asthma Quality of Life Questionnaire. Thus, greater depressive symptom severity was associated with lower asthma-related quality of life. CONCLUSIONS: The QIDS-SR16 showed good reliability and impressive construct validity. Strong psychometric properties of this brief self-report format and its sensitivity to treatment change suggest that the QIDS-SR16 is a valuable clinical tool.     

Assessment of mood states in patients receiving long-term corticosteroid therapy and in controls with patient-rated and clinician-rated scales.

BACKGROUND: Corticosteroids have been used for many years for inflammatory diseases. Mood changes are common during short-term, high-dose, corticosteroid therapy. Virtually no data are available on the mood effects of long-term corticosteroid therapy. OBJECTIVE: To evaluate mood during corticosteroid therapy using standard clinician-rated and patient-rated measures. METHODS: Outpatients receiving prednisone therapy (7.5 mg/d for 6 months) and similar controls were enrolled. Current mood was evaluated using the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), Brief Psychiatric Rating Scale (BPRS), Internal State Scale (ISS), and a diagnostic interview. RESULTS: Twenty patients and 14 controls were enrolled in the study. Depressive symptom severity as evaluated by the HRSD and ISS depression and well-being subscales and global psychiatric symptom severity as evaluated by the BPRS and ISS perceived conflict subscale were greater in patients receiving prednisone than controls. Manic symptom severity as evaluated by the ISS activation subscale but not the YMRS was higher in patients receiving prednisone. Twelve (60%) of 20 corticosteroid-treated patients met diagnostic criteria for a lifetime prednisone-induced mood disorder. Activation subscale scores did not correlate with YMRS scores. Other ISS subscales showed expected correlations with clinician-rated assessments. CONCLUSIONS: Mood symptoms and disorders are common in corticosteroid-dependent patients. Unlike short-term prednisone therapy, long-term therapy may be more associated with depressive than manic symptoms based on the clinician-rated assessments. The ISS may be more sensitive to mood symptoms with prednisone than clinician-rated scales.     

Working memory and depressive symptoms in patients with schizophrenia and substance use disorders

Background. Substance abuse is highly prevalent in schizophrenia and it has been associated with negative consequences on the course of the pathology. Regarding cognition, the prevailing literature has produced mixed results. Some groups have reported greater cognitive impairments in dual diagnosis schizophrenia, while other groups have described the reverse.

Objective. The current cross-sectional study sought to investigate the potential differences in psychiatric symptoms and cognition between schizophrenia patients with and without substance use disorders.

Methods. Fifty-three schizophrenia patients were divided into two groups: with (n=30) and without (n=23) a substance use disorder (DSM-IV criteria). Psychiatric symptoms were measured with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). Psychomotor speed and spatial working memory were measured using Cambridge Neuropsychological Tests Automated Battery (CANTAB).

Results. Patients in the dual diagnosis group displayed more severe depressive symptoms and poorer strategy during the working memory task.

Conclusions. These results are in keeping with the prevailing literature describing negative consequences of substance abuse in schizophrenia. Substance abuse may exacerbate depressive symptoms and interfere with metacognition in schizophrenia.     

Depression and anxiety in patients with hereditary angioedema

BackgroundHereditary angioedema (HAE) is characterized by edematous swelling attacks of the face, extremities, abdomen, genitalia, and upper airway. The potential for laryngeal swelling makes the disease life-threatening, and the swelling elsewhere contributes to the significant burden of illness. The increased risk for mental health disorders in HAE is due to the burden of disease and possibly associated activation of the immune system.ObjectiveTo determine the prevalence of depression and anxiety in HAE patients and the most high-yield features of depression to target in a clinical encounter.MethodsDepression and anxiety symptoms were evaluated using the 29 items of the Hamilton Depression Rating Scale along with the 14-item Hamilton Anxiety Rating Scale. The sample size was 26 participants with a diagnosis of type 1 or 2 HAE drawn from a cohort of 60 adult patients. In addition, a literature search was performed regarding how immune modulation affects depression and anxiety.ResultsA total of 39% of participants were identified as experiencing depression of mild (50%), moderate (40%), or severe (10%) levels. Fifteen percent of participants displayed prominent anxiety, half of whom had mild anxiety, 25% moderate anxiety, and 25% severe anxiety. The literature on inflammation and depression suggests a possible link between HAE and depression.ConclusionOur data and the literature support that depression and anxiety symptoms are common in patients with HAE and may be secondary to chronic disease burden, associated pathophysiologic features, or both. Treatment that addresses the psychosocial and mental health of HAE patients is critical for best practice.     

The interrelations between spiritual well-being,pain interference and depressive symptoms in patients with multiple sclerosis

Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.     

Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts

Objective

To evaluate the effect of isoflavones derived from red clover extracts (MF11RCE) over anxiety and depressive symptoms among postmenopausal women.

Methods

One hundred and nine postmenopausal women aged 40 or more were randomly assigned to receive two daily capsules of MF11RCE (80 mg red clover isoflavones, Group A) or placebo of equal appearance (Group B) for a 90-day period. After a washout period of 7 days, medication was crossed over and taken for 90 days more. Anxiety and depressive symptoms were measured at baseline, 90 and 187 days with the Hospital Anxiety and Depression Scale (HADS) and Zung's Self Rating Depression Scale (SDS).

Results

After receiving the MF11RCE compound the total HADS (anxiety and depression subscale scores also) and the total SDS scores decreased significantly. This effect was equivalent to a 76.9% reduction in the total HADS score (76% for anxiety and 78.3% for depression) and an 80.6% reduction in the total SDS score. After placebo, total HADS (anxiety and depression subscale also) and total SDS scores also decreased significantly in comparison to baseline but only equivalent to an average 21.7% decline.

Conclusion

Red clover derived isoflavones (MF11RCE) were effective in reducing depressive and anxiety symptoms among postmenopausal women.     

Rating depression in normals and depressives: observer versus self-rating scales

Different methods of assessing depression and anxiety were tested in 20 patients suffering from a major depressive disorder with melancholia and 20 matched control subjects. Depressives were assessed before and after treatment with amitriptyline and normals were retested at the same interval. The scales used were: Paykel's Clinical Interview for Depression--which is an expanded version of the Hamilton Depression Rating Scale; the Brief Depression Rating Scale; and Symptom Questionnaire (SQ). All scales discriminated sensitively between patients and normals and the scores changed substantially with treatment. Except for the well-being subscales of the SQ, the scales showed an adequate test-retest reliability in normals. Although all scales were suitable for the measurement of depression, they differed in psychometric properties. For example, the Depression subscale of the SQ showed an unusually high test-retest reliability in normals, whereas the Contentment subscale was unreliable. Yet, the latter has been found to be highly sensitive in detecting differences between the effects of psychotropic drugs and placebo in drug trials, so it appears to measure sensitively a fleeting mood. The combined use of all three scales in patients with affective disorders yields information that might not be revealed if only one scale is used.     

Review of screening instruments for postpartum depression

Summary This paper presents a review and discussion of eight self-report measures used to assess for depressive symptoms in the postpartum period. Because postpartum depression is a significant mental health problem, there is a need for reliable and valid screening instruments. Published psychometric data (e.g., reliability, sensitivity, specificity, positive predictive value, concurrent validity) of each self-report instrument are presented and critiqued. Results suggest that the Edinburgh Postnatal Depression Scale is the most extensively studied measure with postpartum women with moderate psychometric soundness. This review illustrates the need for more research in this area. Issues involved in the selection of measures are considered. Implications for clinical practice, research, culture and language are discussed.