The Melancholia Scale and the Newcastle Scales

Bech, Per; Gjerris, Annette; Andersen, J.; Bøjholm, S.; Kramp, Peter; Tg, Bolwig; Kastrup, Marianne; Clemmesen, L; Oj, Rafaelsen

doi:10.1192/bjp.143.1.58

Cited by 66 publications

(13 citation statements)

References 11 publications

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“…The uncertain reliability on the N1 may illustrate the clinical difficulties in diagnosing melancholy. In other clinical settings [34], however, it has been possible to get a higher reliability measure on the N1 with an ICC of 0.81. The clinicians participating in this study may have been more trained in diagnosing melancholy since several different criteria for melancholy were used, and this may have been the main reason for their higher reliability.…”

Section: Strengthsmentioning

confidence: 99%

“…HDS [33]. Over the years, the HDS has become the most widely used interview scale and analyses of the HDS [34,44] and the N1 [34,35] report high standards of validity and reliability. In a recent publication [43], the N1 has been used as the golden standard when distinguishing between endogenous and psychogenic depressions.…”

Section: Strengthsmentioning

confidence: 99%

“…As previously described, the DSM-III and DSM-III-R criteria were used in the Axis I analysis. The 10-item Newcastle 1 Depression Rating Scale from 1965 (N1) [34,35] was used in the analyses of Axis II and IV symptomatology, i.e., the N1 item 'deviant personality' was used in Axis II analysis and the N1 item 'psychological stressors' was used in Axis IV analysis. The complete N1 scale was applied to a subsample of 439 in-and out-patients.…”

Section: Clinical Assessmentsmentioning

confidence: 99%

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Gender Differences in Severity, Symptomatology and Distribution of Melancholia in Major Depression

Stage

Kragh-Soerensen

2003

Psychopathology

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Background: Studies of gender differences in the clinical presentation of depression have provided divergent results. This study aimed at analyzing gender differences in severity, symptomatology and distribution of melancholia in major depression. Sampling and Methods: The study comprised 930 in- and out-patients (652 women, 278 men) from 6 randomized controlled trials. All patients fulfilled DSM-III or DSM-III-R criteria for major depression. The 17-item Hamilton Depression Scale (HDS) was applied to all patients. A multi-axial evaluation was completed using the Newcastle 1 Depression Rating Scale from 1965 for melancholia (N1) in a subsample of patients (n = 439). A factor analysis on the HDS was performed. Non-parametric statistical tests were used and only gender differences greater than 20% were considered clinically relevant. Results: The median on the HDS total score was 22 and the median number of symptoms was 13 for both men and women. Presentation of specific symptoms was similar for men and women. The factor analysis revealed no gender differences, and neither did analyses on symptoms of Axes II and IV. According to the N1, 80% of the men and 66% of the women suffered from melancholic depression (p = 0.004). Conclusions: In a large and broad sample of in- and out-patients with major depression, the severity and symptomatology of depression were similar for men and women. Melancholic depression was significantly more frequent among male than female patients. Inclusion and exclusion criteria in the randomized controlled trials provided a selected group of patients, which limited the generalisability of the results to an exclusive subgroup of patients treated for depression in routine clinical practice.

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Section: Strengthsmentioning

confidence: 99%

Section: Strengthsmentioning

confidence: 99%

Section: Clinical Assessmentsmentioning

confidence: 99%

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Gender Differences in Severity, Symptomatology and Distribution of Melancholia in Major Depression

Stage

Kragh-Soerensen

2003

Psychopathology

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“…In our previous study with these scales [Bech et al, 1983] we have developed the item steps from the original point scale (absent = 0, present = 1) to 3 points, as 'present' was subdivided into 1 = mild or doubtful and 2 = marked. In table I the transformations between SADD and the Newcas tle items are indicated.…”

Section: Statistical Index For Endogenous Depression (Newcastle Scales)mentioning

confidence: 99%

World Health Organization Schedule for Standardized Assessment of Depressive Disorders (WHO/SADD-5)

Bech¹,

Gjerris²,

Andersen³

et al. 1984

Psychopathology

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In this study we have examined four parts of the 5th revision of the World Health Organization schedule for Standardized Assessment of Depressive Disorders (WHO/SADD-5): (I) items that cover the present depressive state; (II) items that cover the psychiatric history; (III) a global assessment scale for the severity of depression, and (IV) the current ICD-9 diagnosis. Our analysis was based on a comparison of the interobserver reliability of item combinations leading to DSM-III, RDC, Newcastle and Melancholia Scale classifications of patients with depressive disorders. To facilitate these combinations we had added 4 items to SADD: (a) quality of depression, (b) persistence of depression, (c) reactivity of symptoms, and (d) accusations of others. Our results showed that WHO/SADD-5 has an acceptable degree of interobserver reliability both at the levels of global assessment of severity of depression and ICD-9 diagnosis, whereas the item combinations obtained lower intraclass coefficients. However, the item analysis focused on two SADD subscales of acceptable interobserver reliability: a severity scale of 16 items selected from our Melancholia Scale, and a diagnostic scale of another 10 items selected from the two Newcastle Scales.

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“…Patients with depressive states were simulated with numbers (generated by a standard method) to represent scores on the items contained in the Melancholia Scale (MES) (Bech & Rafaelsen, 1980;Bech, 1981;Bech et al 1983). The MES consists of 11 items, selected from the Hamilton Depression Scale (HDS) (Hamilton, 1960) and the Cronholm-Ottosson Scale (Cronholm & Ottosson, 1960) for their validity in evaluating the severity of depressive states.…”

Section: Simulated Casesmentioning

confidence: 99%

Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis

1986

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SynopsisVariations within and between observer-judges reduce the accuracy of clinical research. Judgement Analysis allows strategies to be developed and applied which reduce variation in judgement. The prediction that the removal of important sources of error variance by this means would reduce the likelihood of committing a Type 2 Error was supported by the application of Judgement Analysis to assessments by 15 psychiatrists of 92 patients in a clinical trial of 2 antidepressive treatments. The statistical significance of differences between the effect of the treatments on the severity of depression was increased, and significant differences appeared earlier. Ten stimulated patient profiles were also converted into narrative case histories, enacted by experienced psychiatrists or psychologists and videotaped. The participants' judgements of the overall severity of the depression were in good agreement with those they had made on the original cases. Videotapes so prepared help training to reduce variation in observation, just as Judgement Analysis can lead to reductions in the variation of judgement.

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The Melancholia Scale and the Newcastle Scales

Cited by 66 publications

References 11 publications

Gender Differences in Severity, Symptomatology and Distribution of Melancholia in Major Depression

Gender Differences in Severity, Symptomatology and Distribution of Melancholia in Major Depression

World Health Organization Schedule for Standardized Assessment of Depressive Disorders (WHO/SADD-5)

Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis

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