Psychometric properties of responses by clinicians and older adults to a 6-item Hebrew version of the Hamilton Depression Rating Scale (HAM-D6)

BMC Psychiatry

Liat Ayalon⁴  Per Bech¹  Margalit Goldfracht²  Norm O’Rourke⁵  Yaacov G Bachner³ 

[1] Department of Psychiatry, Frederiksborg General Hospital, Hilleord, Denmark;Community Division, Clalit Health Services, Tel Aviv, Israel and Department of Family, Health Care, Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel;Department of Public Health and the Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 653, Beer-Sheva 84105, Israel;Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel;Faculty of Arts and Social Sciences, Simon Fraser University, Burnaby, (BC), Canada

关键词: Elderly;    Hebrew;    Hamilton depression rating scale;    Depression;   

Others  :  1124191
DOI  :  10.1186/1471-244X-13-2

 received in 2012-11-01, accepted in 2012-12-27,  发布年份 2013

【 摘 要 】

Background

The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D₆ is used most widely in large degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale_.

Methods

A total of 153 Israelis 75 years of age on average participated in this study. The HAM-D₆ was examined using confirmatory factor analytic (CFA) models separately for both patient and clinician responses.

Results

Reponses to the HAM-D₆ suggest that this instrument measures a unidimensional construct with each of the scales’ six items contributing significantly to the measurement. Comparisons between self-report and clinician versions indicate that responses do not significantly differ for 4 of the 6 items. Moreover, 100% sensitivity (and 91% specificity) was found between patient HAM-D₆ responses and clinician diagnoses of depression.

Conclusion

These results indicate that the Hebrew HAM-D₆ can be used to measure and screen for depressive symptoms among elderly patients.

【 授权许可】

   
2013 Bachner et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Richards D: Prevalence and clinical course of depression: a review. Clin Psychol Rev 2011, 31(7):1117-1125.
• [2]American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Revised 4th ed; 2000.
• [3]Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B: Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007, 370:851-858.
• [4]Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997, 349:1436-1442.
• [5]Van Marwijk H, Hoeksema HIL, Hermas J, Kaptein AA, Mulder JD: Prevalence of depressive symptoms and depressive disorder in primary care patients over 65 years of age. Fam Pract 1994, 11:80-84.
• [6]Williams JWJ, Kerber CA, Mulrow CD, Medina A, Aguilar C: Depressive disorders in primary care: prevalence, functional disability, and identification. J Gen Intern Med 1995, 10:7-12.
• [7]Cuijpers F, Smith P: Excess mortality in depression: a meta-analysis of community studies. J Affect Disord 2002, 72:36-227.
• [8]Kiecolt-Glaser JK, Glaser R: Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002, 53:873-876.
• [9]Saczynski JS, Beiser A, Seshadri S, Auerbach S, Wolf PA, Au R: Depressive symptoms and risk of dementia: The Framingham Heart Study. Neurology 2010, 75:35-41.
• [10]Hamilton M: A rating scale for depression. J Neurosurg 1960, 23:56-62.
• [11]Hamilton M: Development of a rating sale for primary depressive illness. Br J Soc Clin Psychol 1967, 6:278-296.
• [12]Bech P, Allerup P, Gram LFN, Rosenberg R, Jacobsen O, Nagy A: The Hamilton Depression Scale: evaluation of objectivity using logistic models. Acta Psychiatr Scand 1981, 63:290-299.
• [13]Carmody TJ: The Montgomery–Asberg and the Hamilton ratings of depression: a comparison of measures. Eur Neuropsychopharmacol 2006, 16:601-611.
• [14]Lecrubier Y, Bech P: The Ham D6 is more homogeneous and as sensitive as the Ham D17. Eur Psychiat 2007, 22:252-255.
• [15]Licht RW, Qvitzau S, Allerup P, et al.: Validation of the Bech-Rafaelsen Melnacholia Scale and the Hamilton Depression Scale in patients with major depression: Is the total score a valid measure of illness severity? Acta Psychiatr Scand 2005, 111:144-149.
• [16]Santor DA, Coyne JC: Examining symptoms expression as a function of symptom severity: item performance on the Hamilton Rating Scale for depression. Psychol Assessment 2001, 13:127-139.
• [17]Bagby RM, Ryder AG, Schuller DR, Marshall MB: The Hamilton Depression Rating Scale: Has the gold standard become a lead weight? Am J Psychiatry 2004, 161:2163-2177.
• [18]Korner A, Lauritzen L, Abelskov K, et al.: Ratings scales for depression in the elderly: external and internal validity. J Clin Psychiatry 2007, 68:384-389.
• [19]Maier W, Philipp M: Improving the assessment of severity of depressive states: a reduction of the Hamilton Depression Scale. Pharmacopsychiatry 1985, 18:114-115.
• [20]Gibbons RD, Clark DC, Kupfer DJ: Exactly what does the Hamilton Depression Rating Scale measure? J Psychiatr Res 1993, 27:259-273.
• [21]Entsuah R, Shaffer M, Zhang J: A critical examination of the sensitivity of unidimensional scales derived from the Hamilton Depression Rating Scale of antidepressant drug effects. J Psychiatr Res 2002, 36:437-448.
• [22]Faries D, Herrera J, Rayamajhi J, DeBrota D, Demitrack M, Potter WZ: The responsiveness of the Hamilton Depression Rating Scale. J Psychiatr Res 2000, 34:3-10.
• [23]McIntyre RS, Konarski JZ, Mancini DA, Fulton KA, Parikh SV, Grigoriadis S, Grupp LA, Bakish D, Filteau M, Gorman C, Nemeroff CB, Kennedy SH: Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale. CMAJ 2005, 173:1327-1334.
• [24]Ballesteros J, Bobes J, Bulbena A, Luque A, Dal-Ré R, Ibarra N, Güemes I: Sensitivity to change, discriminative performance, and cutoff criteria to define remission for embedded short scales of the Hamilton Depression Rating Scale (HAMD). J Affect Disord 2007, 102:93-99.
• [25]Bech P, Gram LF, Dein E, Jacobson O, Vitger J, Bolwing TG: Quantitative rating of depressive states. Acta Psychiatr Scand 1975, 51:161-170.
• [26]Bech P, Wilson BP, Wessel T, Junde M, Fava M: A validation analysis of self-reported HAM-D6 versions. Acta Psychiatr Scand 2009, 119:298-03.
• [27]Bech P, Cialdella P, Haugh MC, et al.: Meta-analysis of randomized controlled trials of fluoxetine v. placebo and tricyclic anidepressants in the short-term treatment of major depression. Br J Psychiatry 2000, 176:421-428.
• [28]Faries D, Herrera J, Raymajhi J, DeBrota D, Demitrack M, Potter WZ: The responsiveness of the Hamilton Depression Rating Scale. J Psychiatr Res 2000, 34:3-10.
• [29]Koller M, Aaronson NK, Blazeby J, et al.: Translation procedures for standardized quality of life questionnaires: The European Organization for Research and Treatment of Cancer (EORTC) approach. Eur J Cancer 2007, 43:1810-1820.
• [30]Callahan EJ, Bertakis KD, Azari R, Robbins JA, Helms LJ, Leigh JP: Association of higher costs with symptoms and diagnosis of depression. J Fam Pract 2002, 51:540-544.
• [31]First MB, Spitzer RI, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Administration Booklet: Clinician Version; 1997.
• [32]Shalev A, Sahar T, Abramovitz M: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Department of Psychiatry: Hadassah University Hospital, Jerusalem, Israel; 1996.
• [33]Bech P, Lunde M, Bech-Andersen G, Lindberg L, Martiny K: Psychiatric outcome studies: Does treatment help the patient? Nord J Psychiatry 2007, 61(46):4-80.
• [34]Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33:159-174.
• [35]Hu LT, Bentler PM: Cut off criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 1999, 6:1-55.