Diagnostic Conversion to Bipolar Disorder in Unipolar Depressed Patients Participating in Trials on Antidepressants

Holmskov, Jens; Licht, Rasmus W; Andersen, Kjeld; Stage, Tore Bjerregaard; Nilsson, Flemming Mørkeberg; Stage, Kurt Bjerregaard; Valentin, Jan Brink; Bech, Per; Nielsen, René Ernst

doi:10.1016/j.eurpsy.2016.08.006

Cited by 14 publications

(13 citation statements)

References 51 publications

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“…However, when Prisciandaro and Tolliver [73] recently evaluated the psychometric properties of the MADRS in bipolar depression, significant measurement problems were identified. In contrast, by means of DIF analysis, we have shown that HAM-D 6 has the same good psychometric properties in bipolar depression as in unipolar depression [24,26]. HAM-D 6 can, therefore, be considered as a suitable alternative to MADRS in the measurement of bipolar depression.…”

Section: Discussionmentioning

confidence: 99%

“…However, the studies by Kyle et al [21], Licht et al [18], and Bobes et al [23] only considered patients with unipolar depression. To assess whether the unipolar/bipolar “mixing” of these populations introduced a bias, we performed a differential item functioning (DIF) analysis of the Holmskov et al [24] study in which 35 of the 102 patients (34%) in the original Danish University Antidepressant Group (DUAG) [25] study had converted to bipolar disorder. This DIF analysis showed that there was no bias in this respect.…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D<sub>6</sub>)

Timmerby

Andersen

Søndergaard

et al. 2017

Psychother Psychosom

100

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Background: In a study aimed at identifying the items carrying information regarding the global severity of depression, the 6-item Hamilton Depression Rating Scale (HAM-D₆) was derived from the original 17-item version of the scale (HAM-D₁₇). Since then, the HAM-D₆ has been used in a wide range of clinical studies. We now provide a systematic review of the clinimetric properties of HAM-D₆ in comparison with those of HAM-D₁₇ and the Montgomery Asberg Depression Rating Scale (MADRS). Methods: We conducted a systematic search of the literature in PubMed, PsycInfo, and EMBASE databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Studies reporting data on the clinimetric validity of the HAM-D₆ and either the HAM-D₁₇ or MADRS in non-psychotic unipolar or bipolar depression were included in the synthesis. Results: The search identified 681 unique records, of which 51 articles met the inclusion criteria. According to the published literature, HAM-D₆ has proven to be superior to both HAM-D₁₇ and MADRS in terms of scalability (each item contains unique information regarding syndrome severity), transferability (scalability is constant over time and irrespective of sex, age, and depressive subtypes), and responsiveness (sensitivity to change in severity during treatment). Conclusions: According to the published literature, the clinimetric properties of HAM-D₆ are superior to those of both the HAM-D₁₇ and MADRS. Since the validity of HAM-D₆ has been demonstrated in both research and clinical practice, using the scale more consistently would facilitate translation of results from one setting to the other.

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D<sub>6</sub>)

Timmerby

Andersen

Søndergaard

et al. 2017

Psychother Psychosom

100

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“…Conflicting results were obtained for the scalability of the unstructured version of the HAM-D 17 . Mokken coefficients ranging from 0.24 [172] to 0.35 [169] were found, indicating that the HAM-D 17 is a multidimensional rating scale. Similarly, Bobes et al [98] and Kyle et al [100] questioned the scalability of the unstructured version of the HAM-D 21 .…”

Section: Scalability Of the Different Versions Of The Ham-dmentioning

confidence: 99%

“…Bech and his research group conducted a number of studies in which they analyzed the scalability of the various versions of the HAM-D [14,20,96,98,100,[165][166][167][168][169][170][171][172]. In these studies, including a recent paper by da Silva et al [173], the HAM-D 6 was found to have an excellent level of scalability with Mokken coefficients ranging from 0.42 [172] to 0.65 [169]. Studies using the Rasch analysis further confirmed the scalability of the unstructured version of the HAM-D 6 [96,165,170].…”

Section: Scalability Of the Different Versions Of The Ham-dmentioning

confidence: 99%

The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions

Carrozzino

Patierno

Fava

et al. 2020

Psychother Psychosom

178

110

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The format of the original Hamilton Rating Scale for Depression (HAM-D) was unstructured: only general instructions were provided for rating individual items. Over the years, a number of modified versions of the HAM-D have been proposed. They differ not only in the number of items, but also in modalities of administration. Structured versions, including item definitions, anchor points and semi-structured or structured interview questions, were developed. This comprehensive review was conducted to examine the clinimetric properties of the different versions of the HAM-D. The aim was to identify the HAM-D versions that best display the clinimetric properties of reliability, validity, and sensitivity to change. The search was conducted on MEDLINE, Scopus, Web of Science, and PubMed, and yielded a total of 35,473 citations, but only the most representative studies were in-cluded. The structured versions of the HAM-D were found to display the highest inter-rater and test-retest reliability. The Clinical Interview for Depression and the 6-item HAM-D showed the highest sensitivity in differentiating active treatment from placebo. The findings indicate that the HAM-D is a valid and sensitive clinimetric index, which should not be discarded in view of obsolete and not clinically relevant psychometric criteria. The HAM-D, however, requires an informed use: unstructured forms should be avoided and the type of HAM-D version that is selected should be specified in the registration of the study protocol and in the methods of the trial. scale exceeds 21,000 on Scopus. Hamilton himself recommended, however, to use only the first 17 items of the HAM-D 21 since the last 4 symptoms (i.e., diurnal variation, depersonalization/derealization, paranoid and obsessional/compulsive symptoms) were either not considered part of the disease, or they were relatively uncommon, or they were not considered features related to depression severity [2,3]. Over the years, a number of modifications of the scale have been proposed and several versions of the HAM-D have been developed and come into use [4,5].

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“…While major depressive disorder is more common and bipolar disorder more rare, distinguishing the two is clinically difficult as they share many common features, especially during depressive episodes (Phillips and Kupfer, 2013). Indeed, a recent study by Holmskov et al (2016) found that 1 in 5 participants in clinical trials for antidepressants underwent a diagnostic conversion from unipolar depression to bipolar depression over time. This means that a substantial number of people with bipolar disorder were actually misdiagnosed, sometimes for years.…”

mentioning

confidence: 99%

Finding the Stripes: Distinguishing Bipolar Disorder From Major Depressive Disorder

MacMaster

2017

EBioMedicine

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Diagnostic Conversion to Bipolar Disorder in Unipolar Depressed Patients Participating in Trials on Antidepressants

Cited by 14 publications

References 51 publications

A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D<sub>6</sub>)

A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D<sub>6</sub>)

The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions

Finding the Stripes: Distinguishing Bipolar Disorder From Major Depressive Disorder

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