The relations between observer-rating and self-report of depressive symptomatology.

Sayer, Nina A.; Sackeïm, Harold A.; Moeller, James R.; Prudic, Joan; Devanand, Devangere P.; Coleman, Eliza; Kiersky, Judith E.

doi:10.1037/1040-3590.5.3.350

Cited by 75 publications

(51 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies, including a meta-analysis, have determined, however, that scales administered by clinicians may be more sensitive to change than self-rated measures, particularly in short-term studies. 28,29 A practical and meaningful marker of remission should simultaneously evaluate both symptomatic and functional outcomes. HAMD-7 is primarily a symptom-measurement tool, inviting the need for additional monitoring of functional outcomes.…”

Section: Researchmentioning

confidence: 99%

Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale

McIntyre

Konarski²,

Mancini³

et al. 2005

Canadian Medical Association Journal

111

View full text Add to dashboard Cite

O ptimal management of major depressive disorders is enhanced by applying a chronic illnessmanagement model with precise and measurable therapeutic endpoints. 1 In contradistinction to several other chronic medical disorders, biological markers of illness activity in depression do not currently exist. In the interim, therapeutic progress is monitored by evaluating changes in the severity of depressive symptoms and in functional domains. This concatenation of findings is particularly disconcerting in view of the fact that most depressed patients in either primary care or psychiatric settings are not systematically evaluated with objective quantifiable measures -a modifiable deficiency in patient management. [2][3][4][5][6] The most frequently reported symptomatic outcome measure in clinical trials of antidepressants has been response to treatment, arbitrarily defined as a reduction of 50% or more in total symptom severity from a pretreatment assessment of the patient's depression. 7 A categorical response to therapy that fails to achieve a fully asympomatic remitted state furnishes an unsatisfactory outcome, in that it includes patients with ongoing disease activity that is clinically significant. Patients who show improvement in symptom severity but are not asymptomatic are at risk for developing chronic depression, and continue to be vulnerable to poor outcomes and comorbid medical disorders. [8][9][10] Remission is an objective outcome indicated by a quantifiable score with a depressive symptom measurement tool. In antidepressant clinical trials, the 17-item Hamilton Depression Rating Scale (HAMD-17) has been the "gold standard" for use. HAMD-17, however, has not been accepted by clinicians for many reasons, 11,12 notably psychometric deficiencies and the length of time needed to administer it.Although several brief rating scales for depression that attempt to improve upon the limitations of HAMD-17 have recently been validated and reviewed, [11][12][13][14][15][16][17][18] none that are brief, currently available and use a remission cut-off score that correlates with the most frequently cited definition of remission (a HAMD-17 score ≤ 7) 7 have been validated in both tertiary mental health and primary care settings.Our broad objective in using HAMD-7 was to improve upon the conceptual and pragmatic deficiencies ascribed to HAMD-17. HAMD-7 was originally derived from analyses of a natural practice database at a tertiary care centre composed of patients diagnosed with a major depressive disorder (n = 248). 14 The HAMD-17 items that were endorsed in a previous study 14 by 70% of depressed patients and were most sensi- Background: Symptomatic remission is the optimal outcome in depression. A brief, validated tool for symptom measurement that can indicate when remission has occurred in mental health and primary care settings is unavailable. We evaluated a 7-item abbreviated version (HAMD-7) of the 17-item Hamilton Depression Rating Scale (HAMD-17) in a randomized controlled clinical trial of patients with major de...

show abstract

Section: Researchmentioning

confidence: 99%

Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale

McIntyre

Konarski²,

Mancini³

et al. 2005

Canadian Medical Association Journal

111

View full text Add to dashboard Cite

show abstract

“…The HAM-D was selected as the primary outcome due to the fact that it is considered the 'gold standard' of antidepressant treatment trials and is considered superior by many over self-reported scales [54]. This overall poor response to treatment may be due to the fact that some participants, who were on doses of 20 mg/day for 6 weeks, were treated sub-optimally.…”

Section: Discussionmentioning

confidence: 99%

Genetic predictors of response to treatment with citalopram in depression secondary to traumatic brain injury

Lanctôt¹,

Rapoport

Chan³

et al. 2010

Brain Injury

View full text Add to dashboard Cite

Objectives-To determine which serotonergic system-related single nucleotide polymorphisms (SNPs) predicted variation in treatment response to citalopram in depression following a traumatic brain injury (TBI).Methods-Ninety (50 M/40 F, aged 39.9, SD = 18.0 years) post-TBI patients with a major depressive episode (MDE) were recruited into a 6-week open-label study of citalopram (20 mg/ day). Six functional SNPs in genes related to the serotonergic system were examined: serotonin transporter (5HTTLPR including rs25531), 5HT1A C-(1019)G and 5HT2A T-(102)C, methylene tetrahydrofolate reductase (MTHFR) C-(677)T, brain-derived neurotrophic factor (BDNF) val66met and tryptophan hydroxylase-2 (TPH2) G-(703)T. Regression analyses were performed using the six SNPs as independent variables: Model 1 with response (percentage Hamilton Depression (HAMD) change from baseline to endpoint) as the dependent variable and Model 2 with adverse event index as the dependent variable (Bonferroni corrected p-value <0.025). Results-MTHFR CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptConclusion-Results suggest that polymorphisms in genes related to the serotonergic system may help predict short-term response to citalopram and tolerability to the medication in patients with MDE following a TBI. KeywordsTraumatic brain injury; serotonin receptors; serotonin transporter; brain derived neurotrophic factor (BDNF); methylenetetrahydrofolate reductase (MTHFR); tryptophan hydroxylase (TPH)

show abstract

“…Patient self-reports or clinician ratings of depressive symptoms can be affected by cultural context, alliance, personality style, age, and prior or current life experiences. For example, before treatment initiation, the relationship between patient and clinician ratings has repeatedly been shown to be modest, sharing on average only 25% common variance (Sayer et al, 1993). The degree of discrepancy between patient and clinician ratings of depression severity may be affected by incentives, depression subtype, and the patient's cognitive capacity.…”

Section: Ascertainment Of Remissionmentioning

confidence: 99%

Report by the ACNP Task Force on Response and Remission in Major Depressive Disorder

Rush¹,

Kraemer

Sackeïm

et al. 2006

Neuropsychopharmacol

608

489

View full text Add to dashboard Cite

This report summarizes recommendations from the ACNP Task Force on the conceptualization of remission and its implications for defining recovery, relapse, recurrence, and response for clinical investigators and practicing clinicians. Given the strong implications of remission for better function and a better prognosis, remission is a valid, clinically relevant end point for both practitioners and investigators. Not all depressed patients, however, will reach remission. Response is a less desirable primary outcome in trials because it depends highly on the initial (often single) baseline measure of symptom severity. It is recommended that remission be ascribed after 3 consecutive weeks during which minimal symptom status (absence of both sadness and reduced interest/pleasure along with the presence of fewer than three of the remaining seven DSM-IV-TR diagnostic criterion symptoms) is maintained. Once achieved, remission can only be lost if followed by a relapse. Recovery is ascribed after at least 4 months following the onset of remission, during which a relapse has not occurred. Recovery, once achieved, can only be lost if followed by a recurrence. Day-to-day functioning and quality of life are important secondary end points, but they were not included in the proposed definitions of response, remission, recovery, relapse, or recurrence. These recommendations suggest that symptom ratings that measure all nine criterion symptom domains to define a major depressive episode are preferred as they provide a more certain ascertainment of remission. These recommendations were based largely on logic, the need for internal consistency, and clinical experience owing to the lack of empirical evidence to test these concepts. Research to evaluate these recommendations empirically is needed.

show abstract

The relations between observer-rating and self-report of depressive symptomatology.

Cited by 75 publications

References 45 publications

Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale

Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale

Genetic predictors of response to treatment with citalopram in depression secondary to traumatic brain injury

Report by the ACNP Task Force on Response and Remission in Major Depressive Disorder

Contact Info

Product

Resources

About