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

R Uher, A Farmer, W Maier, M Rietschel, J Hauser, A Marusic, O Mors, A Elkin, R J Williamson, C Schmael, N Henigsberg, J Perez, J Mendlewicz, J G E Janzing, A Zobel, M Skibinska, D Kozel, A S Stamp, M Bajs, A PlacentinoM Barreto, P McGuffin, K J Aitchison

Research output: Contribution to journalArticlepeer-review

232 Citations (Scopus)

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
Original languageEnglish
Pages (from-to)289 - 300
Number of pages12
JournalPsychological Medicine
Volume38
Issue number2
Early online date9 Oct 2007
DOIs
Publication statusPublished - Feb 2008

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