Measuring depression: comparison and integration of three scales in the GENDEP study
Measuring depression: comparison and integration of three scales in the GENDEP study
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DOI：
10.1017/s0033291707001730
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发表时间：
2008-02-01
影响因子：
6.9
通讯作者：
Aitchison, K. J.
中科院分区：
文献类型：
--
作者：
Uher, R.;Farmer, A.;Aitchison, K. J.
背景。许多量表被用来估计抑郁症的严重程度。然而，自我报告与临床医师评定的差异、个体症状的多维度以及个体症状在总得分中的不同权重可能会影响测量的效度。在本研究中，我们检验并整合了三种常用的评定量表的心理测量特性。采用17项汉密尔顿抑郁评定量表（HAMD-17）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和贝克抑郁量表（BDI）对660例成人单相抑郁症患者进行多中心药物遗传研究。运用项目反应理论（IRT）和因子分析方法评价被试的心理测量特征和抑郁真实严重程度，并对项目进行分组，得出因子得分。MADRS和BDI提供了内部一致但相互不同的抑郁严重程度估计。HAMD-17内部不一致，包含一些不太适合门诊患者的项目。因子分析表明，抑郁因素占主导地位。一个包含三个维度的模型，即“观察到的情绪和焦虑”、“认知”和“神经植物”，提供了对抑郁症严重程度的更详细的描述。MADRS和BDI可以作为抑郁症严重程度的补充测量。提出了三个因素得分进行外部验证。
Background. A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales.Method. The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores.Results. The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely 'observed mood and anxiety', 'cognitive' and 'neurovegetative', provided a more detailed description of depression severity.Conclusions. The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.