The effects of chlordiazepoxide on self-rated depression, anxiety, and well-being

Abstract

The main purpose of this study was to compare sensitivity of several self-rating scales to drug effects in anxious and depressed patients. Twenty-two distressed nonpsychotic outpatients completed a double-blind crossover trial of chlordiazepoxide and placebo. All self-rating scales of depression, anxiety, somatic symptoms, and feelings of inadequacy discriminated significantly between chlordiazepoxide and placebo. The decrease in self-rated depression was about equal to the decrease in self-rated anxiety. Subscales describing well-being were more sensitive to drug effects than subscales describing symptoms. A questionnaire (The Symptom Questionnaire) and one of the self-rating scales (Symptom Rating Test) were more sensitive than global self-rating scales, global observer-rating scales, and the Hamilton Anxiety Rating Scale. Some of the self-rating scales discriminated significantly between drug and placebo even when the sample size was reduced to two subsamples of eight patients each. High and significant positive correlations between two scales did not indicate equal sensitivity in discriminating between drug and placebo.

Rating well-being and distress

“…As a result, psychometric assessment in psychiatric research is mostly based on appraisal of psychopathological dysfunction. However, there is evidence that in drug trials, subscales describing well-being are more sensitive 2 or as sensitive 3 to drug effects as subscales describing symptoms. Further, wellbeing is a major component of quality of life, 4,5 the role of which is attracting increasing attention 6±9 in affective (mood and anxiety) disorders.…”

Clinimetrics and Clinical Psychometrics: Macro- and Micro-Analysis

“…Kellner’s SQ [32] is a simple and brief self-report questionnaire which contains single-word items instead of questions. The total number of items (92 items) has been increased in order to improve the scale’s sensitivity [33]. Responders should answer yes/no or true/false to the item, instead of measuring the frequency and severity of symptoms.…”

Measurement of Subclinical Changes during Lithium Prophylaxis: A Longitudinal Study

“…The SQ was found in several studies to fulfill the psychometric requirements for a pure state or distress measure [Kellner, 1987], includ ing high sensitivity to detect changes, ability to discriminate repeatedly between different populations or an active psychotropic drug and placebo, and high test-retest correlations in normals [Buckman and Kellner, 1985;Fava et al, 1982aFava et al, , b, 1983Fava et al, , 1984Fava et al, , 1986Kellner et al, 1974Kellner et al, , 1979Michelacci et al, 1984], The aim of this study was to provide a longitudinal observation of psychological distress in bipolar patients and normals.…”