Outcome in depression (II): beyond the Hamilton Depression Rating Scale

CNS Spectrums ◽  
2020 ◽  
pp. 1-5 ◽  
Author(s):  
Koen Demyttenaere ◽  
Glenn Kiekens ◽  
Ronny Bruffaerts ◽  
Philippe Mortier ◽  
Philip Gorwood ◽  
...  
Keyword(s):  
Negative Affect ◽  
Positive Affect ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Present Report ◽  
Added Value ◽  
Patient Treatment ◽  
Hedonic Tone ◽  
Patient Centered ◽  
Hamilton Depression Rating Scale

Abstract Background. The Leuven Affect and Pleasure Scale (LAPS) was developed as an outcome measure in major depressive disorder (MDD) tha treflects patient treatment expectations. The present report investigates whether the LAPS negative affect, the LAPS positive affect, and the LAPS hedonic tone have added value on top of the Hamilton Depression Rating Scale (HAMD) in explaining generic as well as patient-centered outcomes. Methods. A total of 109 outpatients with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, criteria for MDD were assessed over 8 weeks of antidepressant treatment. At baseline and after 2, 4, and 8 weeks, the LAPS, HAMD, Snaith–Hamilton Pleasure Scale (SHAPS), Positive and Negative Affect Scale (PANAS), and Sheehan Disability Scale were administered. The Clinical Global Impression of Improvement (CGI-I) and the Patient Global Impression of Improvement (PGI-I) were also administered at endpoint. Results. Changes in LAPS negative affect, LAPS positive affect, and LAPS hedonic tone explain 14% of the additional variance in CGI-I, 21% in PGI-I, 37% in cognitive functioning, 32% in overall functioning, 31% in “my life is meaningful,” and 45% in “I feel happy.” Compared to standard scales (PANAS and SHAPS), the LAPS negative affect, LAPS positive affect, and LAPS hedonic tone differentiate better between different levels of CGI-I or PGI-I. Conclusions. The LAPS has added value (on top of the HAMD) in explaining changes in both generic outcomes (CGI-I/PGI-I) and patient-centered dimensions. The LAPS negative and positive affects and the LAPS hedonic tone differentiate CGI-I and PGI-I scores better than corresponding scales supposed to cover the same domains.

Outcome in depression (I): why symptomatic remission is not good enough

CNS Spectrums ◽  
2020 ◽  
pp. 1-7
Author(s):  
Koen Demyttenaere ◽  
Glenn Kiekens ◽  
Ronny Bruffaerts ◽  
Philippe Mortier ◽  
Philip Gorwood ◽  
...  
Keyword(s):  
Negative Affect ◽  
Positive Affect ◽  
Cognitive Functioning ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Patient Treatment ◽  
Positive And Negative Affect ◽  
Healthy Controls ◽  
Hedonic Tone ◽  
Overall Functioning

Abstract Background. The Leuven Affect and Pleasure Scale (LAPS) is a depression outcome measure aiming to better reflect patient treatment expectations. We investigated the evolution of the LAPS and some comparator scales during antidepressant treatment and compared scores of remitters with scores of healthy controls. Methods. A total of 109 outpatients with Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) major depressive disorder were assessed over 8 weeks of antidepressant treatment. At baseline and after 2, 4, and 8 weeks, the LAPS as well as the Hamilton Depression Rating Scale (HAMD), the Snaith–Hamilton Pleasure Scale (SHAPS), the Positive and Negative Affect Scale (PANAS), and the Sheehan Disability Scale (SDS) were administered. Healthy controls consisted of 38 Italian adults and 111 Belgian students. Results. Correlations between baseline positive and negative affect were only moderate (R between −0.20 and −0.41). LAPS positive affect and hedonic tone showed higher correlations with LAPS cognitive functioning, overall functioning, meaningfulness of life, and happiness than HAMD scores or PANAS negative affect. HAMD remission was associated with normal levels of LAPS negative affect but with significantly lower levels of LAPS positive affect, hedonic tone, cognitive functioning, overall functioning, meaningfulness of life, and happiness. The scores on the latter subscales only reached healthy control scores when the HAMD approached a score of 0 or 1. Conclusions. The standard definition of remission (HAMD cutoff of 7) is probably adequate for remitting negative mood, but not good enough for recovering positive mood, hedonic tone, functioning, or meaningfulness of life.

Is there enough “interest in and pleasure in” the concept of depression? The development of the Leuven Affect and Pleasure Scale (LAPS)

CNS Spectrums ◽  
2017 ◽  
Vol 24 (02) ◽  
pp. 265-274 ◽  
Author(s):  
Koen Demyttenaere ◽  
Philippe Mortier ◽  
Glenn Kiekens ◽  
Ronny Bruffaerts
Keyword(s):  
College Students ◽  
Negative Affect ◽  
Positive Affect ◽  
Rating Scale ◽  
Positive Mood ◽  
Hedonic Tone ◽  
Meaningful Life ◽  
Independent Variables ◽  
Depressed College Students ◽  
Overall Functioning

ObjectivePresence of negative mood (depressed mood) and anhedonia (lack of interest and pleasure) are considered core symptoms of depression, while absence of positive mood is not taken into account. It is therefore remarkable that the depression scales routinely used to assess changes during antidepressant treatment (Hamilton Depression Rating Scale [HDRS], Montgomery–Åsberg Depression Rating Scale [MADRS]) do not really take into account anhedonia. Several scales were developed to assess positive mood and hedonic tone, but they only partially cover the multidimensional concept. Therefore we developed a new 16-item questionnaire, the Leuven Affect and Pleasure Scale (LAPS), to assess negative affect, positive affect, and hedonic tone.MethodsThis first article on the LAPS questionnaire reports on the correlations between the different items, on the factor analysis, and on the differences found in 3 groups of subjects : healthy college students (N=138), depressed but still functioning college students (N=27), and severely depressed inpatients (N=38). These differences were calculated using univariate general linear models with Bonferroni post-hoc testing, and effect sizes were expressed in η2.ResultsNegative and positive affect were only moderately correlated, and the 4 independent variables (cognitive functioning, overall functioning, meaningful life, and happiness) had stronger correlations with positive affect than with negative affect. The major difference in negative affect was between healthy college students and depressed college students, positive affect was different between the 3 groups, and the major difference for hedonic tone was between depressed college students and depressed inpatients. Affiliative positive affect and the affiliative hedonic function were well preserved, even in depressed inpatients.ConclusionsThis preliminary report suggests that the LAPS offers a comprehensive assessment of negative and positive affect, of hedonic tone, and of independent variables (cognitive functioning, overall functioning, meaningful life, and happiness). Clinically relevant differences in subscores were found in 3 groups of subjects with variable levels of depression (healthy subjects, mildly depressed subjects, and severely depressed inpatients).

Edwards Inventory of Emotions: Assessing Emotions in Athletes and Nonathletes

1995 ◽  
Vol 80 (2) ◽  
pp. 444-446 ◽  
Author(s):  
Steven W. Edwards
Keyword(s):  
Negative Affect ◽  
Positive Affect ◽  
Rating Scale ◽  
Self Report ◽  
Specific Factor ◽  
General Factor ◽  
Independent College ◽  
College Age ◽  
Point Rating Scale ◽  
Affect Factor

A self-report inventory was created on which respondents indicated the frequency of occurrence of 40 basic emotions using a 5-point rating scale. The inventory was administered to two matched, independent college-age samples ( ns = 562 and 414) and the factorial validity was tested. Factor 1 was a general factor reflecting over-all Positive Affect. Factor 2 was a more specific factor reflecting Profound Negative Affect. Factor 3 was also a specific factor reflecting Moderate Negative Affect. Subsequent analyses gave significantly greater scores for athletes over nonathletes and men over women on the Profound Negative Affect subscale. Women had significantly higher Positive Affect scores. It was concluded that the questionnaire had sufficient technical merit for use in research.

scholarly journals Brief Body Scan Meditation Intervention on Positive and Negative Affect among Alcohol Dependence Patients

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Shobha Yadav
Keyword(s):  
Negative Affect ◽  
Alcohol Dependence ◽  
Positive Affect ◽  
Stress Reduction ◽  
Lower Cost ◽  
Rating Scale ◽  
Body Scan ◽  
Treatment As Usual ◽  
Alcohol Dependence Syndrome ◽  
Experimental Group

Although effect of mindfulness based stress reduction (MBSR) are effective and highly valued, but all the patients will not be interested due to extensive time and cost. Brief interventions (e.g., body scans) may be used by individuals, at a lower cost and with little training. Aim: To study the effect of body scan meditation on negative and positive affect in patients with alcohol dependence. Method: The present study was conducted on patients with alcohol dependence in Central Institute of Psychiatry, Ranchi. The study samples were collected from 30 in-patients with alcohol dependence syndrome (ADS) using a self-rating scale. After that the subjects who were randomly assigned to receiving body scan meditation underwent 45 minutes guided meditation and 15 minutes discussion for one week. Subjects assigned to other group did not receive body scan meditation. However, both the groups received pharmacological treatment as usual. After the intervention, subjects in both the groups were revaluated. Results: Patients in experimental group had significantly less severe dependence on alcohol and did not show significant reduction in negative affect and increment in positive affect after one week intervention of body scan meditation. Conclusion: There is no significant reduction in negative and increment in positive affect after receiving one week of body scan meditation intervention in alcohol dependence patients.

scholarly journals Gambaran Emosi dan Tingkat Kecemasan pada Pasien Hipertensi di Puskesmas Bahu

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Richard K. Kati ◽  
Hendri Opod ◽  
Cicilia Pali
Keyword(s):  
Negative Affect ◽  
Positive Affect ◽  
Rating Scale ◽  
Anxiety Level ◽  
Dominant Negative ◽  
The Other ◽  
Hypertensive Patients ◽  
Hamilton Anxiety Rating Scale ◽  
Severe Anxiety ◽  
Hamilton Anxiety

Abstract: Anxiety and poor emotional management may trigger the occurence of hypertension. In reverse, hypertension is able to cause uncontrolled anxiety and emotion. This study was aimed to determine the emotional and anxiety level of patients with hypertension at Puskesmas Bahu (Primary Heath Center). This was a descriptive study with a cross-sectional design. Hamilton Anxiety Rating Scale was used to measure the anxiety level, and Positive Affect-Negative Affect Schedule was used to determine the emotion overview of hypertensive patients. Subjects of this study were all hypertensive patients who came to Pukesmas Bahu during the period of October to November 2017. There were 78 patients as respondents involved in this study; 49 (62.8%) females and 29 (37.2%) males. The results showed that 4 (5.1%) respondents had dominant negative affect, while the other 74 (94.9%) respondents had dominant positive affect. Dealing with the anxiety level, there were 23 (29.5%) respondents with mild anxiety level, 21 (26.9%) respondents with severe anxiety level, 20 (25.6%) respondents with moderate anxiety level, 10 (12.8%) respondents had no anxiety, and the other 4 (5.1%) respondents had very severe anxiety. Conclusion: Most hypertensive patients at Puskesmas Bahu had dominant positive affect frequently associated with mild anxiety.Keywords: emotion, anxiety, affect, hypertensionAbstrak: Kecemasan dan manajemen emosi yang buruk dapat mencetuskan terjadinya hipertensi. Hipertensi juga dapat menyebabkan kecemasan dan emosi menjadi tidak terkendali. Penelitian ini bertujuan untuk mengetahui gambaran emosi dan tingkat kecemasan pada pasien hipertensi di Puskesmas Bahu. Jenis penelitian ialah deskriptif dengan desain potong lintang. Hamilton Anxiety Rating Scale digunakan untuk mengukur tingkat kecemasan dan Positive Affect Negative Affect Schedule digunakan untuk mengetahui gambaran emosi pasien hipertensi. Subyek penelitian ialah seluruh pasien hipertensi yang datang berkunjung ke Puskesmas Bahu pada periode Oktober sampai November 2017. Terdapat 78 responden dalam penelitian ini terdiri dari 49 orang (62,8%) perempuan dan 29 orang (37,2%) laki-laki. Gambaran emosi yang didapatkan ialah sebanyak 4 responden (5,1%) memiliki afek negatif yang dominan sedangkan 74 responden (94,9%) memiliki afek positif yang dominan. Gambaran tingkat kecemasan yang didapatkan ialah kecemasan ringan sebanyak 23 orang (29,5%), kecemasan berat 21 orang (26,9%), kecemasan sedang 20 orang (25,6%), tidak ada kecemasan sebanyak 10 orang (12,8%), dan kecemasan berat sekali sebanyak 4 orang (5,1%). Simpulan: Sebagian besar pasien dengan hipertensi di Puskesmas Bahu memiliki afek positif yang dominan dan tersering disertai kecemasan ringan.Kata kunci: emosi, kecemasan, afek, hipertensi

Unna boot therapy impact on wellbeing, hope and spirituality in venous leg ulcer patients: a prospective clinical trial

2020 ◽  
Vol 29 (4) ◽  
pp. 214-220 ◽  
Author(s):  
Elaine Cristina Faria ◽  
Tatiana Loiola ◽  
Geraldo Magela Salomé ◽  
Lydia Masako Ferreira
Keyword(s):  
Clinical Trial ◽  
Life Satisfaction ◽  
Negative Affect ◽  
Positive Affect ◽  
Subjective Wellbeing ◽  
Rating Scale ◽  
Compression Therapy ◽  
Venous Leg Ulcer ◽  
Care Clinic ◽  
The Impact

Objective: To assess the impact of Unna boot therapy on subjective wellbeing, hope and spirituality in patients with venous leg ulcers (VLU). Method: This was a prospective, descriptive, analytical, multicentre clinical trial conducted in a nursing care and education centre, an outpatient wound care clinic and a primary health care unit in Brazil. Adult patients with VLUs took part in the study. Patients with diabetic foot ulcers and mixed ulcers were excluded. A questionnaire assessing sociodemographic and religious characteristics of patients, the Subjective Wellbeing Scale, the Spirituality Self-Rating Scale (SSRS), and the Herth Hope Index (HHI) were administered to all patients. Results: A total of 60 patients (63.3% female; 86.7% aged ≥60 years) participated. Before Unna boot therapy, 65%, 66.7% and 65% of patients reported a score of one on positive affect, negative affect and life satisfaction, respectively, indicating poor subjective wellbeing. After one month of compression therapy, 66.7%, 50.0%, and 80.0% of patients reported a score of three for each element positive affect, negative affect and life satisfaction, respectively, showing a significant improvement in subjective wellbeing (p=0.029). A significant increase in total SSRS scores (p=0.017) was found between baseline (mean: 9.77) and one month of treatment (mean: 25.47), indicating a significant increase in a sense of spirituality. There was also a significant increase in total HHI values (p=0.009) between baseline (mean: 15.68) and one month of compression therapy (mean: 39.38), suggesting a significant increase in hope among patients. Conclusion: Patients with VLUs treated with Unna boot therapy in this study showed significant improvement in subjective wellbeing, spirituality and hope for cure.

scholarly journals Do side effects of antidepressants impact efficacy estimates based on the Hamilton Depression Rating Scale? A pooled patient-level analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fredrik Hieronymus ◽  
Alexander Lisinski ◽  
Elias Eriksson ◽  
Søren Dinesen Østergaard
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Reuptake Inhibitor ◽  
Side Effect ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Gastrointestinal Function ◽  
Somatic Anxiety ◽  
Hamilton Depression Rating Scale ◽  
Patient Level

AbstractThe Hamilton Depression Rating Scale (HDRS-17) measures symptoms that may overlap with common antidepressant side effects (e.g., sexual dysfunction), thus making it possible that side effects of antidepressant treatment are erroneously rated as symptoms of depression, and vice versa. This study uses patient-level data from previously conducted antidepressant treatment trials to assess whether side effect ratings co-vary with HDRS-17 ratings. Data from all HDRS-17-rated, industry-sponsored pre- and post-marketing trials (n = 4647) comparing the serotonin and noradrenaline reuptake inhibitor, duloxetine, to placebo and/or to a selective serotonin reuptake inhibitor were pooled; three studies, which utilised sub-therapeutic doses, did not have symptom-level ratings available and could not be included. Severity was assessed for side effects related to sleep, somatic anxiety, gastrointestinal function, and sexual dysfunction. Analysis of covariance was used to assess the relation between these side effects and ratings of relevant HDRS-17-derived outcome parameters. Side effects related to sleep, somatic anxiety and sexual dysfunction significantly and exclusively associated with higher scores on HDRS-17 items measuring the corresponding domains. Side effects related to gastrointestinal function associated with higher HDRS-17 item scores on all assessed domains. Treatment outcome was significantly related to side effect severity when assessed using HDRS-17-sum (beta 0.32 (0.074), p < 0.001), but not when the HDRS-6-sum-score (beta 0.035 (0.043), p = 0.415) or the depressed mood item (beta 0.007 (0.012), p = .527) were used as effect parameters. That some HDRS-17 items co-vary with common antidepressant side effects suggests some of these adverse events are counted twice, potentially leading to an underestimation of antidepressant efficacy.

Predicting stress in male and female psychiatric patients and healthy volunteers

2009 ◽  
Vol 37 (8) ◽  
pp. 1081-1093 ◽  
Author(s):  
Madeleine Zöller ◽  
Trevor Archer
Keyword(s):  
Healthy Volunteer ◽  
Negative Affect ◽  
Positive Affect ◽  
Patient Group ◽  
Psychiatric Patient ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Icd 10 ◽  
Healthy Volunteer Group ◽  
Volunteer Group

The present study was aimed at examining the relationships between affective status, mood, and stress in both a psychiatric patient group (n = 100) and a healthy volunteer group (n = 101 persons), as well as trying to find evidence of a gender effect. The Positive Affect (PA) and Negative Affect (NA), Stress and Energy (SE), Dispositional optimism (LOT), Comprehensive Psychopathological Rating Scale (CPRS) self-rating scale and the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) were used. Psychiatric disability had a detrimental effect on stress, energy, and optimism. The results indicated that stress was predicted by NA and that PA was counterpredictive for stress. Different effects were found for males and females, with NA predicting stress for both men and women, while the DIP-Q general criteria were stress predictors for males only and PA was counterpredictive for stress in men. Stress as a dependent variable was not significantly predicted by either DIP-Q general criteria, CPRS-depression, CPRS-compulsion, or CPRS-anxiety. It was predicted by negative affect and counterpredicted by positive affect. Data suggest that negative affect was the most important factor in predicting stress. The healthy volunteer group was found to be less affected by stress than the psychiatric patient group.

Preliminary Findings on the Use of Session Questionnaires to Improve Clinician-Client Alliance With Special Consideration to Clinical Education

2015 ◽  
Vol 25 (1) ◽  
pp. 50-60
Author(s):  
Anu Subramanian
Keyword(s):  
Graduate Students ◽  
Clinical Education ◽  
Clinical Decision Making ◽  
Rating Scale ◽  
Treatment Effectiveness ◽  
Clinical Decision ◽  
Added Value ◽  
Therapeutic Outcomes ◽  
Specific Feedback ◽  
Stakeholder Perspective

ASHA's focus on evidence-based practice (EBP) includes the family/stakeholder perspective as an important tenet in clinical decision making. The common factors model for treatment effectiveness postulates that clinician-client alliance positively impacts therapeutic outcomes and may be the most important factor for success. One strategy to improve alliance between a client and clinician is the use of outcome questionnaires. In the current study, eight parents of toddlers who attended therapy sessions at a university clinic responded to a session outcome questionnaire that included both rating scale and descriptive questions. Six graduate students completed a survey that included a question about the utility of the questionnaire. Results indicated that the descriptive questions added value and information compared to using only the rating scale. The students were varied in their responses regarding the effectiveness of the questionnaire to increase their comfort with parents. Information gathered from the questionnaire allowed for specific feedback to graduate students to change behaviors and created opportunities for general discussions regarding effective therapy techniques. In addition, the responses generated conversations between the client and clinician focused on clients' concerns. Involving the stakeholder in identifying both effective and ineffective aspects of therapy has advantages for clinical practice and education.

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