Predicting response to treatment and discriminating bipolar and depression symptoms using Hamilton Depression Rating Scale

Abstract

Objective: The present study aims to compare the diagnostic ability of the HAMD 17 items with shorter versions of 7 and 6 items. Methods: A total of 133 patients from a 6 month clinical trial diagnosed with mood disorders (60.2% with Major Depressive Disorder and 39.8% with bipolar type I disorder) were recruited. Results: The 17 items HAMD scale showed similar results as compared with shorter versions. Furthermore, almost all patients' diagnosed with Major Depressive Disorder scored more compared to Bipolar Disorder, but the difference was not significant. Conclusion: This study allows that the use of a shorter version of HAMD might be an adequate possibility, and also that depressive symptoms were similar among groups. RESUMOObjetivo: O presente estudo tem por objetivo investigar a habilidade diagnóstica da HAMD 17 comparada a versões breves de 7 e 6 itens. Métodos: Foram selecionados 133 participantes recrutados de um ensaio clínico (60,2% com Depressão Maior e 39,8% com Transtorno Bipolar tipo I). Resultados: A versão de 17 itens da HAMD mostrou resultados similares quando comparada às versões breves. Ademais, quase todos os pacientes diagnosticados com Depressão Maior apresentaram maiores pontuações, contudo, essa diferença não foi estatisticamente significativa. Conclusão: Este estudo demonstra que o uso de uma versão breve da HAMD pode ser uma possibilidade adequada e que os sintomas depressivos se mostraram similares entre os grupos de bipolares e depressivos.

Usefulness of Hamilton rating scale for depression subset scales and full versions for electroconvulsive therapy

“…However, this compares similarly to other studies using these subset scales. When these are used in either ECT [ 16 ] or antidepressant populations [ 20 ], the Cronbach’s alpha varies from 0.44 to 0.71, thus suggesting that they were mostly unreliable in ECT and also in antidepressant study populations. Indeed, it would appear that previous assessments of the subset scales have found them to be unsatisfactory and our findings suggest this is even more so in an ECT population.…”

“…All four versions are nested within the HAMD-17 and do not contain any of the additional items found within the HAMD-21 or HAMD-24, although none of these additional items proved to have any individual predictive ability. Most research investigating therapeutic outcome prediction has used the HAMD-17 as the primary outcome and for defining response and remission [ 3 , 16 , 20 ]. Fourthly, there was reduced variability in HAMD-24 scores at baseline as an inclusion criterion for entry to the original EFFECT-Dep trial was a score of ≥21 on the HAMD-24, meaning there was a limited lower range.…”

“…Various studies have examined the predictive value in ECT of depression severity rating scales such as the HAMD and Montgomery Asberg Depression Rating Scale (MADRS) [ 16 , 19 , 20 ]. To our knowledge, only one study to date has investigated the ability of a HAMD subset scale to predict outcome with ECT [ 16 ].…”