Improving the Assessment of Severity of Depressive States: A Reduction of the Hamilton Depression Scale

Clinical use of the Hamilton Depression Rating Scale: is increased efficiency possible? A post hoc comparison of Hamilton Depression Rating Scale, Maier and Bech subscales, Clinical Global Impression, and Symptom Checklist-90 scores

“…The HDRS is criticized as being sensitive to somatic symptoms (eg, somatic illness or side effects of drugs) [11,15,27,28], for not rating all 9 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition domains, its unequal weightings of different symptoms, and for the multidimensionality of the HDRS total score [13,21,[29][30][31]. Multidimensionality is important to cover the maximum range of clinical features of major depressive disorder but does not necessarily measure depression severity.…”

“…Multidimensionality is important to cover the maximum range of clinical features of major depressive disorder but does not necessarily measure depression severity. Multidimensional scales can be misleading when measurement of severity and treatment response is concerned [13,21,28], especially when the measured depressive symptoms do not change proportionally with depression severity. Finally, some reports emphasize that the HDRS systematically favors (sedative) tricyclic antidepressants (TCAs) above selective serotonin reuptake inhibitors (SSRIs) [27,[32][33][34][35].…”

“…However, for the purpose of reference, subscale scores must remain anchored to the original HDRS. To identify shorter unidimensional subscales, Maier and Philipp [28] used Rasch and Mokken analyses, and Gibbons et al [29] used factor analysis. Bech et al [36] developed another 6-item subscale.…”

Prevalence and clinical characteristics of major depressive disorder (MDD) without depressed mood in Koreans with MDD: results from the CRESCEND study

“…Replication studies with larger samples and [12]; adding the scores on the mood, guilt, work and interest, psychic anxiety, agitation and retardation items. d Defined by Manber et al [13]; adding the scores on initial insomnia, middle insomnia.…”

“…Clinical characteristics including depressive symptoms, core depressive symptoms, insomnia symptoms, anxiety symptoms, overall psychiatric symptoms, suicidal ideation, global severity, social and occupational function, and quality of life were evaluated using the 17-item Hamilton Depression Rating Scale (HAM-D) [11], Maier-6 subscale [12], insomnia subscale [13], Hamilton Anxiety Rating Scale (HAM-A) [14], Brief Psychiatric Rating Scale (BPRS) [15], Scale for Suicidal Ideation (SSI-Beck) [16], Clinical Global Impression of Severity (CGI-S) [17], Social and Occupational Functional Assessment Scale (SOFAS) [18], and WHOQOL-BREF (WHO Quality of Life Assessment instrument-abbreviated version) [19], respectively. The HAM-D, HAM-A, BPRS, CGI-S, and SOFAS are non-self-rated and symptom-based rating scales, whereas the SSI-Beck and WHOQOL-BREF are self-rated scales.…”