Factor structure and dimensionality of the two depression scales in STAR*D using level 1 datasets |
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Authors: | Bech P Fava M Trivedi M H Wisniewski S R Rush A J |
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Institution: | a Psychiatric Research Unit, Frederiksborg General Hospital, Copenhagen University, Hillerød, Denmarkb Massachusetts General Hospital, Dept. of Psychiatry, Harvard University, Boston, United Statesc Southwestern Medical School, University of Texas, United Statesd Department of Epidemiology, University of Pittsburgh, United Statese Clinical Sciences, Duke-NUS, Singapore |
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Abstract: | BackgroundThe factor structure and dimensionality of the HAM-D17 and the IDS-C30 are as yet uncertain, because psychometric analyses of these scales have been performed without a clear separation between factor structure profile and dimensionality (total scores being a sufficient statistic).MethodsThe first treatment step (Level 1) in the STAR*D study provided a dataset of 4041 outpatients with DSM-IV nonpsychotic major depression. The HAM-D17 and IDS-C30 were evaluated by principal component analysis (PCA) without rotation. Mokken analysis tested the unidimensionality of the IDS-C6, which corresponds to the unidimensional HAM-D6.ResultsFor both the HAM-D17 and IDS-C30, PCA identified a bi-directional factor contrasting the depressive symptoms versus the neurovegetative symptoms. The HAM-D6 and the corresponding IDS-C6 symptoms all emerged in the depression factor. Both the HAM-D6 and IDS-C6 were found to be unidimensional scales, i.e., their total scores are each a sufficient statistic for the measurement of depressive states.LimitationsSTAR*D used only one medication in Level 1.ConclusionsThe unidimensional HAM-D6 and IDS-C6 should be used when evaluating the pure clinical effect of antidepressive treatment, whereas the multidimensional HAM-D17 and IDS-C30 should be considered when selecting antidepressant treatment. |
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Keywords: | Hamilton depression scale Inventory of Depressive Symptomatology Principal component analysis Item response theory analysis |
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