Validation of the Bech-Rafaelsen Melancholia Scale and the Hamilton Depression Scale in patients with major depression; is the total score a valid measure of illness severity?

2005 ◽  
Vol 111 (2) ◽  
pp. 144-149 ◽  
Author(s):  
R. W. Licht ◽  
S. Qvitzau ◽  
P. Allerup ◽  
P. Bech
Keyword(s):  
Major Depression ◽  
Depression Scale ◽  
Illness Severity ◽  
Hamilton Depression Scale ◽  
Valid Measure

scholarly journals Depression in women infected with HIV

2006 ◽  
Vol 28 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Valéria Antakly de Mello ◽  
André Malbergier
Keyword(s):  
Major Depression ◽  
Hiv Infection ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Asymptomatic Group ◽  
Dsm Iv ◽  
Women With Hiv ◽  
Major Depressive Episodes ◽  
Depressive Episodes

OBJETIVE:The number of women with HIV infection has been on the rise in recent years, making studies of the psychiatric aspects of this condition very important. The aim of this study was to evaluate the prevalence of major depression in women with HIV infection. METHOD: A total of 120 women were studied, 60 symptomatic (with AIDS symptoms) and 60 asymptomatic (without AIDS symptoms). Sociodemographic data were collected, and depressive disorders were identified. The instruments used to evaluate the depressive disorders were the SCID, DSM-IV, 17-item Hamilton depression scale, Hamilton depression scale for nonsomatic symptoms and the Beck depression scale. RESULTS: The prevalence of major depression was 25.8% and was higher in the symptomatic group than in the asymptomatic group (p = 0.002). CONCLUSIONS: The prevalence of major depressive episodes in women with HIV infection is high, and women with AIDS-related symptoms are more often depressed than are those who have never presented such symptoms.

The internal and external validity of the Major Depression Inventory in measuring severity of depressive states

2003 ◽  
Vol 33 (2) ◽  
pp. 351-356 ◽  
Author(s):  
L. R. OLSEN ◽  
D. V. JENSEN ◽  
V. NOERHOLM ◽  
K. MARTINY ◽  
P. BECH
Keyword(s):  
Major Depression ◽  
External Validity ◽  
Depression Scale ◽  
Internal Validity ◽  
Depressive Illness ◽  
Hamilton Depression Scale ◽  
Major Depression Inventory ◽  
Icd 10 ◽  
Internal And External Validity ◽  
Depressive States

Background. We have developed the Major Depression Inventory (MDI), consisting of 10 items, covering the DSM-IV as well as the ICD-10 symptoms of depressive illness. We aimed to evaluate this as a scale measuring severity of depressive states with reference to both internal and external validity.Method. Patients representing the score range from no depression to marked depression on the Hamilton Depression Scale (HAM-D) completed the MDI. Both classical and modern psychometric methods were applied for the evaluation of validity, including the Rasch analysis.Results. In total, 91 patients were included. The results showed that the MDI had an adequate internal validity in being a unidimensional scale (the total score an appropriate or sufficient statistic). The external validity of the MDI was also confirmed as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0·86, P[les ]0·01, Spearman 0·80, P[les ]0·01).Conclusion. When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

scholarly journals Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients

2009 ◽  
Vol 31 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Beatriz Azevedo dos Anjos Godke Veiga ◽  
Vanderci Borges ◽  
Sonia Maria César de Azevedo Silva ◽  
Fabrício de Oliveira Goulart ◽  
Maysa Seabra Cendoroglo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Major Depression ◽  
Beck Depression Inventory ◽  
Geriatric Patients ◽  
Rating Scale ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Yahr Scale ◽  
Disease Rating

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

A Patient with a Resistant Major Depression Disorder Treated with Deep Brain Stimulation in the Inferior Thalamic Peduncle

Neurosurgery ◽  
2005 ◽  
Vol 57 (3) ◽  
pp. 585-593 ◽  
Author(s):  
Fiacro Jiménez ◽  
Francisco Velasco ◽  
Rafael Salin-Pascual ◽  
José A. Hernández ◽  
Marcos Velasco ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Major Depression ◽  
Depression Scale ◽  
Borderline Personality ◽  
Hamilton Depression Scale ◽  
Global Assessment Of Functioning ◽  
Major Depression Disorder ◽  
Depression Disorder ◽  
Deep Brain ◽  
Stimulation Of

ABSTRACT OBJECTIVE AND IMPORTANCE: The present report explored the effect of electrical stimulation on the inferior thalamic peduncle in a patient with resistant major depression disorder (MDD). CLINICAL PRESENTATION: This report refers to a 49-year-old woman with a history of recurrent episodes of major depression for 20 years (12 episodes and 2 hospitalizations), fulfilling Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised, criteria for MDD; in addition, the patient met criteria for borderline personality disorder and bulimia. Her longest episode of depression with suicidal ideation began 5 years before surgery. The patient's symptom array responded poorly to different combinations of antidepressants, cognitive therapy, and electroconvulsive therapy, which induced improvement only for short periods of time. Immediately before surgery, her Global Assessment of Functioning score was 20 and her Hamilton Depression Scale score ranged from 33 to 42. The patient was proposed for surgery for MDD. INTERVENTION: The patient had bilateral eight-contact electrodes stereotactically implanted for stimulation of areas at and around the inferior thalamic peduncle. Electrode position was corroborated by unilateral electrical stimulation searching for recruiting responses and regional direct current shifts in the electroencephalogram. Recording electrodes were replaced by tetrapolar electrodes for deep brain stimulation and connected to an internalized stimulation system for continuous bipolar stimulation at 130 Hz, 0.45 milliseconds, 2.5 V. Bimonthly follow-up included psychiatric and neuropsychological evaluations performed over the course of 24 months. After 8 months of ON stimulation, the patient entered a double-blind protocol with stimulators turned OFF. Improvement of depression measured by the Hamilton Depression Scale score was evident after initial placement of electrodes without electrical stimulation. Depression relapsed partially at the end of the first week. Electrical stimulation further improved depression, normalizing depression scores and neuropsychological performance. Patient depression scores ranked between 2 and 8 during 8 months of ON stimulation without antidepressant medication. After stimulation was turned OFF, spontaneous fluctuations in patient symptoms reflected by Hamilton Depression Scale and Global Assessment of Functioning scores were documented; these fluctuations disappeared after stimulation was turned on by Month 20. CONCLUSION: Complicated patients with comorbid conditions are common referrals to psychosurgery services. In this report, we present promising results of electrical stimulation of the inferior thalamic peduncle to treat recurrent unipolar depression in a patient with MDD and borderline personality disorder who responded poorly to treatment.

Gender Differences in [123I]-ADAM Binding to Serotonin Transporters in Patients with Major Depression Before and After Treatment with Citalopram

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
K. Uebelhack ◽  
L. Franke ◽  
N. Herold ◽  
M. Plotkin ◽  
H. Amthauer ◽  
...  
Keyword(s):  
Gender Differences ◽  
Major Depression ◽  
Depression Scale ◽  
Brain Regions ◽  
Hamilton Depression Scale ◽  
Serotonin Transporters ◽  
Before And After ◽  
Males And Females ◽  
Depression Disorder ◽  
Analyze Data

Aims:The aim was to determine the relation between characteristics of [123I]-ADAM binding to serotonin transporters (SERT) in several brain regions to different symptoms in patients diagnosed with major depressive disorder (MDD) and to analyze data for males and females separately. Differences of [123I]-ADAM binding in patients before and after treatment with Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant Citalopram were assessed.Method:12 non medicated patients (5 females and 7 males) diagnosed with MDD were examined by SPECT with specific Serotonin transporter radioligand [123I]-ADAM before and after treatment with SSRI Citalopram. We administered the dose of 10 mg Citalopram per day intravenously at first day, followed by a 6 days period of oral application. After 7 days of treatment patients were examined for second time with SPECT. The relationships between [123I]-ADAM binding and different aspects of major depression represented by HAMD items, assessed twice by Hamilton Depression-Scale (HAMD) once at baseline and second after treatment period, were evaluated.Results:We found significant correlations with significant gender differences between singular sub items of HAMD and indices of [123I]-ADAM binding in midbrain before and after treatment. These findings points to the need of data analysis separately in males and females. No correlations between HAMD total scores at baseline and indices were found.Conclusion:SERT availability for 123-ADAM binding in the midbrain in drug naives as well as in treated patients with major depression disorder seems to be related to intensity of sub items in the HAMD and the outcome of treatment.

Responsiveness of observer rating scales by analysis of number of days until improvement in patients with major depression

1998 ◽  
Vol 13 (3) ◽  
pp. 143-145 ◽  
Author(s):  
N Lauge ◽  
K Behnke ◽  
J Søgaard ◽  
B Bahr ◽  
P Bech
Keyword(s):  
Major Depression ◽  
Rating Scales ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Response To Treatment ◽  
Hamilton Depression Scale ◽  
Scale Scores ◽  
Pre Treatment ◽  
Treatment Onset

SummarySeveral well-known observer scales, including the Hamilton Depression Scale (HAM-D), Montgomery-Åsberg Scale (MADRS), Major Depression Rating Scale (MDS), Melancholia Scale (MES), and Inventory for Depressive Symptomatology (IDS) used for measuring severity of depressive states have been compared by their responsiveness in an open trial including patients treated with a combination of citalopram and mianserin. The patients fulfilled the Diagnostic and Statistical Manual (DSM)-IV criteria for major depressive episode, and all scored 18 or more on the HAM-D before treatment. Onset of antidepressant action was defined as an improvement of rating scale scores of 25% or more of pre-treatment scores. A response to treatment was defined as a reduction of 50% or more on the pre-treatment scores. The results showed that the number of treatment days until improvement was 11 to 13 with no difference between the scales. The days until response were between 18 and 21 with no difference between the scales. In conclusion, the depression scales were found to be equal in their ability to detect changes in depressive symptoms during treatment. The mean of days to response was 19 for the combination of citalopram and mianserin. This is similar to the response for the combination of fluoxetine and pinolol.

Residual symptoms after partial remission: an important outcome in depression

1995 ◽  
Vol 25 (6) ◽  
pp. 1171-1180 ◽  
Author(s):  
E. S. Paykel ◽  
R. Ramana ◽  
Z. Cooper ◽  
H. Hayhurst ◽  
J. Kerr ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Drug Treatment ◽  
Partial Remission ◽  
Adverse Outcome ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Illness Episode ◽  
Residual Symptoms ◽  
Early Relapse

SynopsisThis paper draws attention to an important adverse outcome in depression, the occurrence of residual symptoms after partial remission. Among patients with definite major depression followed every 3 months to remission and thereafter, residual symptoms reaching 8 or more on the Hamilton Depression Scale 17-item total were present in 32% (19) of the 60 who remitted below major depression by 15 months. The pattern was of mild but typical depressive symptoms. Residual symptoms were more common in subjects with more severe initial illness, but were not related to any other predictors, including longer prior illness, dysthymia, or lower dose of drug treatment during the illness episode. There were weak associations with personality that might have been consequences of symptom presence. Residual symptoms were very strong predictors of subsequent early relapse, which occurred in 76% (13/17) of those with residual symptoms and 25% (10/40) of those without.

Hypericum in the Treatment of Seasonal Affective Disorders

1994 ◽  
Vol 7 (1_suppl) ◽  
pp. 29-33 ◽  
Author(s):  
B. Martinez ◽  
S. Kasper ◽  
S. Ruhrmann ◽  
H.-J. Möller
Keyword(s):  
Major Depression ◽  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Depression Scale ◽  
Light Condition ◽  
Light Therapy ◽  
Hamilton Depression Scale ◽  
Full Remission ◽  
Significant Difference

Seasonal affective disorder (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn/winter and full remission in spring/summer. Light therapy (LT) has become the standard treatment of this type of depression. Apart from this, pharmacotherapy with antidepressants also seems to provide an improvement of SAD symptoms. The aim of this controlled, single-blind study was to evaluate if hypericum, a plant extract, could be beneficial in treating SAD patients and whether the combination with LT would be additionally advantageous. Patients who fulfilled DSM-III-R criteria for major depression with seasonal pattern were randomized in a 4-week treatment study with 900 mg of hypericum per day combined with either bright (3000 lux, n = 10) or dim (< 300 lux, n = 10) light condition. Light therapy was applied for 2 hours daily. We found a significant (MANOVA, P < .001) reduction of the Hamilton Depression Scale score in both groups but no significant difference between the two groups. Our data suggest that pharmacologic treatment with hypericum may be an efficient therapy in patients with seasonal affective disorder.

scholarly journals Is the antidepressive effect of second-generation antidepressants a myth?

2009 ◽  
Vol 40 (2) ◽  
pp. 181-186 ◽  
Author(s):  
P. Bech
Keyword(s):  
Major Depression ◽  
Effect Size ◽  
Second Generation ◽  
Randomized Clinical Trials ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Acute Therapy ◽  
Antidepressive Effect ◽  
Continuation Therapy ◽  
Meta Analyses

Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of ∼0.30 in favour of antidepressants in the acute therapy of major depression. The clinical significance of an effect size at this level was found to be so poor that these meta-analyses have subscribed to the myth of an exclusively placebo-like effect of second-generation antidepressants. A re-allocation of HAMD items focusing on those items measuring severity of clinical depression, the HAMD6, has identified effect sizes of ⩾0.40 for second-generation antidepressants in placebo-controlled trials for which even a dose–response relationship can be demonstrated. In the relapse-prevention phase during continuation therapy of patients with major depression, the advantage of second-generation antidepressants over placebo was as significant as in the acute therapy phase. To explore a myth is not to deny the facts but rather to re-allocate them.

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