Development and validation of the Affective Self Rating Scale for manic, depressive, and mixed affective states

Abstract

Most rating scales for affective disorders measure either depressive or hypomanic/manic symptoms and there are few scales for hypomania/mania in a self-rating format. We wanted to develop and validate a self-rating scale for comprehensive assessment of depressive, manic/hypomanic and mixed affective states. We developed an 18-item self-rating scale starting with the DSM-IV criteria for depression and mania, with subscales for depression and mania. The scale was evaluated on 61 patients with a diagnosis of affective disorder, predominantly bipolar disorder type I, using Montgomery-Asberg Depression Rating Scale (MADRS), Hypomania Interview Guide-Clinical version (HIGH-C) and Clinical Global Impression scale, modified for bipolar patients (CGI-BP) as reference scales. Internal consistency of the scale measured by Cronbach's alpha was 0.89 for the depression subscale and 0.91 for the mania subscale. Spearman's correlation coefficients (two-tailed) between the depression subscale and MADRS was 0.74 (P<0.01) and between mania subscale and HIGH-C 0.80 (P<0.01). A rotated factor analysis of the scale supported the separation of symptoms in the mania and depression subscale. We established that the self-rating scales sensitivity to identify mixed states, with combined cut-offs on the MADRS and HIGH-C as reference, was 0.90 with a specificity of 0.71. The study shows that the Affective Self Rating Scale is highly correlated with ratings of established interview scales for depression and mania and that it may aid the detection of mixed affective states.

The Functional Anatomy of Psychomotor Disturbances in Major Depressive Disorder

“… ACC, anterior cingulate cortex; AS-18, affektiv skattningsskala 18 ( 59 ); ASL, arterial spin labeling; BP, binding potential; BPD, bipolar disorder depression; CT, computed tomography; DTI, diffusion tensor imaging; DLPFC, dorsolateral prefrontal cortex; EEG, electroencephalography; ERP, event-related potentials; FA, fractional anisotropy; FDG-PET, fluorodeoxyglucose positron emission tomography; fMRI, functional magnetic resonance imaging; HDRS, Hamilton Depression Rating Scale; IBZM, iodobenzamide single-photon emission computed tomography; MDD, major depressive disorder; MRI, magnetic resonance imaging; OFC, orbitofrontal cortex; PD, Parkinson’s disease; PET, positron emission tomography; ROI, region of interest; rCBF, regional cerebral blood flow; RTI-32, (1R-2-exo-3-exo)-8-methyl-3-(4-methylphenyl)-8-azabicyclo[3.2.1]octane-2-carboxylate; SMA, supplementary motor area; SPECT, single-photon emission computed tomography; 99mTc, Technetium-99 . …”

Saving time and money: a validation of the self ratings on the prospective NIMH life-chart method (NIMH-LCM)

“…A helpful rating scale for depression in bipolar disorders has been developed by Berk et al which also captures mixed symptoms [31]. Self-rating scales for mania are scarce and seldom used in clinical trials [30] but the AS-18, a self-rating scale for bipolar disorder, has been developed to assess depressive, manic and mixed affective states [32]. This scale is claimed to be time-efficient and an alternative to the use of two different observer rating scales for mania and depression.…”

Motor Imagery in Bipolar Depression With Slowed Movement

“…Motor retardation was rated with the CORE scale, where retardation (CORE-R) and total score (CORE) were calculated (Hickie et al, 1996). The self-rated affective state was evaluated using the AS-18 scale, where a previous study implicated a retardation factor (AS-18-Retardation [AS-18-R]; Adler et al, 2008). When patient files were reviewed, we did not find any notes indicating secondary parkinsonism around the time of scanning.…”