scholarly journals Trends in (not) using scales in major depression: A categorization and clinical orientation

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Koen Demyttenaere ◽  
Liesbeth Jaspers
Keyword(s):  
Major Depression ◽  
Rating Scales ◽  
Rating Scale ◽  
Assessment Tools ◽  
Treatment Expectations ◽  
Current Trends ◽  
Clinical Orientation ◽  
Current Assessment ◽  
The Individual ◽  
Disease Specific

Abstract Background Standard depression rating scales like the Hamilton Depression Rating Scale and the Montgomery–Åsberg Depression Rating Scale were developed more than 40 years ago. They are mandatory in clinical trials but are for a variety of reasons seldom used in clinical practice. Moreover, most clinicians are less familiar with more recent trends or with some dilemmas in assessment tools for major depression. Methods Narrative review. Results Asssessment tools can be observer-rating or self-rating scales, disease-specific or non–disease-specific scales, subjective scales or objective lab assessments, standard questionnaires or experience sampling methods. An overarching question is to what degree current assessment methods really address the individual patient’s needs and treatment expectations. Conclusions The present paper aims to offer a framework for understanding the current trends in assessment tools that can orientate and guide the clinician.

Depression in Inpatients: Bipolar vs Unipolar

2003 ◽  
Vol 92 (3) ◽  
pp. 1031-1039 ◽  
Author(s):  
Stella Dorz ◽  
Giuseppe Borgherini ◽  
Donatella Conforti ◽  
Caterina Scarso ◽  
Guido Magni
Keyword(s):  
Social Support ◽  
Major Depression ◽  
Social Adjustment ◽  
Rating Scales ◽  
Rating Scale ◽  
Social Impairment ◽  
Symptom Checklist ◽  
Bipolar Patients ◽  
Hamilton Rating Scale ◽  
Social Adjustment Scale

162 depressed inpatients were divided into three diagnostic groups to compare patterns of sociodemographic characteristics, psychopathology, and psychosocial: 35 had a single episode of major depression, 96 had recurrent major depression, and 31 had a bipolar disorder. Psychopathology and psychosocial functioning were measured by clinician-rated scales, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Impression, and self-rating scales, Symptom Checklist-90, Social Support Questionnaire, Social Adjustment Scale. The three groups were comparable on sociodemographic variables, with the exception of education. Univariate analyses showed a similar social impairment as measured by Social Support Questionnaire, Social Adjustment Scale, and no significant differences were recorded for the psychopathology when the total test scores (Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Index, Symptom Checklist-90) were evaluated. Some differences emerged for single items in the Montgomery-Asberg Depression Rating Scale and Symptom Checklist-90. These findings suggest a substantial similarity among the three groups. Results are discussed in terms of the clinical similarities between unipolar and bipolar patients during a depressive episode as well as the limitations of cross-sectional study implies.

Nominations, Ratings, and the Dimensions of Sociometric Status

1997 ◽  
Vol 21 (1) ◽  
pp. 179-199 ◽  
Author(s):  
Gerard H. Maassen ◽  
Jos L. van der Linden ◽  
Wies Akkermans
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Sociometric Status ◽  
Dimensional Model ◽  
One Dimensional ◽  
Individual Level ◽  
Research Designs ◽  
The One ◽  
The Individual ◽  
Group Member

In 1944, U. Bronfenbrenner remarked on the need for a two-dimensional model of sociometric status. The low value of the correlation between the variables liking and disliking-assumed basic dimensions of sociometric status-is often cited as evidence for the correctness of Bronfenbrenner’ssuggestion. Sociometric status is derived from a coalescence of judgements at the individual level. In this article we argue that score attribution at this level (where one group member assesses another) is one-dimensional along the liking-disliking continuum. Two-dimensionality of sociometric status arises at the group level. However, we also show that at this level liking and disliking are not two distinct dimensions, but the poles of just one, the other being visibility (or impact). If the one-dimensional model of liking score attribution on the individual level is accepted, the obvious thing to do is to instruct respondents accordingly. Rating scales are suitable for this. The rating-scale methods we suggested in previous publications (e.g. Maassen, Akkermans, & van der Linden, 1996) are in keeping with this argument. Moreover, these methods may be recommended for their reliability, validity and for the variety of research designs to which they can be applied.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly With Major Depression. Study Protocol of the VESPA Study: A Pragmatic, Multicentre, Open-Label, Parallel-Group, Superiority, Randomized Trial

2020 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label ◽  
Parallel Group

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco ). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19 th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30 th 2021.

scholarly journals Individual response to antidepressants for depression in adults – a meta-analysis and simulation study

2019 ◽  
Author(s):  
Klaus Munkholm ◽  
Stephanie Winkelbeiner ◽  
Philipp Homan
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Simulated Data ◽  
Individual Treatment ◽  
Depression Symptom ◽  
Individual Response ◽  
Inverse Variance ◽  
The Individual ◽  
Symptom Rating

Background The observation that some patients appear to respond better to antidepressants for depression than others encourages the assumption that the effect of antidepressants differs between individuals and that treatment can be personalized. Objective To compare the outcome variance in patients receiving antidepressants with the outcome variance in patients receiving placebo in randomized controlled trials (RCTs) of adults with major depressive disorder (MDD) and to illustrate, using simulated data, components of variation of RCTs. Methods From a dataset comprising 522 RCTs of antidepressants for adult MDD, we selected the placebo-controlled RCTs reporting outcomes on the 17 or 21 item Hamilton Depression Rating Scale or the Montgomery-Asberg Depression Rating Scale and extracted the means and SDs of raw endpoint scores or baseline to endpoint changes scores on eligible depression symptom rating scales. We conducted inverse variance random-effects meta-analysis with the variability ratio (VR), the ratio between the outcome variance in the group of patients receiving antidepressants and the outcome variance in the group receiving placebo, as the primary outcome. An increased variance in the antidepressant group would indicate individual differences in response to antidepressants. Results We analysed 222 RCTs that investigated 19 different antidepressants compared with placebo in 345 comparisons, comprising a total of 61144 adults with an MDD diagnosis. Across all comparisons, the VR for raw endpoint scores was 0.98 (95% CI 0.96 to 1.00, I^2^ = 0%) and 1.00 (95% CI 0.99 to 1.02, I^2^ = 0%) for baseline-to-endpoint change scores. Conclusion Based on these data, we cannot reject the null hypothesis of equal variances in the antidepressant group and the placebo group. Given that RCTs cannot provide direct evidence for individual treatment effects, it may be most reasonable to assume that the average effect of antidepressants applies also to the individual patient.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly with Major Depression. Study Protocol of the Vespa Study: A Pragmatic, Multicentre, Open-Label, Parrallel-Group, Superiority, Randomized Trial

2019 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
Good Clinical Practice ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30th 2021.

scholarly journals Development of an adapted Clinical Global Impression scale for use in Angelman syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Alexander Kolevzon ◽  
Pamela Ventola ◽  
Christopher J. Keary ◽  
Gali Heimer ◽  
Jeffrey L. Neul ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Global Impression ◽  
Angelman Syndrome ◽  
Rating Scales ◽  
Rating Scale ◽  
Fine Motor ◽  
Rater Training ◽  
Specific Symptom ◽  
Symptom Domains ◽  
Disease Specific

Abstract Background The Clinical Global Impression-Severity (CGI-S) and CGI-Improvement (CGI-I) scales are widely accepted tools that measure overall disease severity and change, synthesizing the clinician’s impression of the global state of an individual. Frequently employed in clinical trials for neuropsychiatric disorders, the CGI scales are typically used in conjunction with disease-specific rating scales. When no disease-specific rating scale is available, the CGI scales can be adapted to reflect the specific symptom domains that are relevant to the disorder. Angelman syndrome (AS) is a rare, clinically heterogeneous condition for which there is no disease-specific rating scale. This paper describes efforts to develop standardized, adapted CGI scales specific to AS for use in clinical trials. Methods In order to develop adapted CGI scales specific to AS, we (1) reviewed literature and interviewed caregivers and clinicians to determine the most impactful symptoms, (2) engaged expert panels to define and operationalize the symptom domains identified, (3) developed detailed rating anchors for each domain and for global severity and improvement ratings, (4) reviewed the anchors with expert clinicians and established minimally clinically meaningful change for each symptom domain, and (5) generated mock patient vignettes to test the reliability of the resulting scales and to standardize rater training. This systematic approach to developing, validating, and training raters on a standardized, adapted CGI scale specifically for AS is described herein. Results The resulting CGI-S/I-AS scales capture six critical domains (behavior, gross and fine motor function, expressive and receptive communication, and sleep) defined by caregivers and expert clinicians as the most challenging for patients with AS and their families. Conclusions Rigorous training and careful calibration for clinicians will allow the CGI-S/-I-AS scales to be reliable in the context of randomized controlled trials. The CGI-S/-I-AS scales are being utilized in a Phase 3 trial of gaboxadol for the treatment of AS.

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.

scholarly journals Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children

2021 ◽  
Vol 24 (3) ◽  
Author(s):  
Mariagrazia Di Giuseppe ◽  
Tracy A. Prout ◽  
Lauren Ammar ◽  
Thomas Kui ◽  
Ciro Conversano
Keyword(s):  
Defense Mechanisms ◽  
Rating Scales ◽  
Rating Scale ◽  
Child Psychotherapy ◽  
Self Report ◽  
Ample Evidence ◽  
Defensive Functioning ◽  
Mental Health Literature ◽  
The Individual ◽  
Q Sort

Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children’s defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child’s defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C.

A Rating Scale for Mania: Reliability, Validity and Sensitivity

1978 ◽  
Vol 133 (5) ◽  
pp. 429-435 ◽  
Author(s):  
R. C. Young ◽  
J. T. Biggs ◽  
V. E. Ziegler ◽  
D. A. Meyer
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Global Rating ◽  
Individual Item ◽  
Before And After ◽  
Item Scores ◽  
The Individual

SummaryAn eleven item clinician-administered Mania Rating Scale (MRS) is introduced, and its reliability, validity and sensitivity are examined. There was a high correlation between the scores of two independent clinicians on both the total score (0.93) and the individual item scores (0.66 to 0.92). The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently. The score also correlated with the number of days of subsequent stay in hospital. It was able to differentiate statistically patients before and after two weeks of treatment and to distinguish levels of severity based on the global rating.

Methylphenidate May Treat Apathy Independent of Depression

2005 ◽  
Vol 39 (11) ◽  
pp. 1947-1949 ◽  
Author(s):  
Prasad R Padala ◽  
Frederick Petty ◽  
Subhash C Bhatia
Keyword(s):  
Major Depression ◽  
Treatment Regimen ◽  
Rating Scales ◽  
Rating Scale ◽  
Case Summary ◽  
Long Time ◽  
History Of ◽  
High Degree ◽  
Hamilton Rating Scale

OBJECTIVE To report a case of apathy treated with methylphenidate in which improvement in apathy was independent of improvement of depression. CASE SUMMARY A 47-year-old woman with a 20-year history of recurrent major depression was diagnosed as having significant apathy with lack of initiative and motivation. Over the course of a 4-week treatment regimen with methylphenidate, her apathy, as measured by the Apathy Evaluation Scale, improved, with her score decreasing from 57 to 31. During this period, her depression, as assessed by the 21-item Hamilton Rating Scale for Depression, remained unchanged. DISCUSSION Our report of improvement of apathy with methylphenidate is consistent with other reports in the literature, although previous studies have not specifically used the rating scales to assess apathy. Even though this patient had experienced apathy for a long time, it had not been detected due to lack of direct questioning. In this case, as noted, the improvement of apathy was independent of improvement in depression. CONCLUSIONS A high degree of suspicion and specific inquiry is required for identification of apathy. Once detected, methylphenidate may be beneficial in its treatment, a strategy that may work independently of augmentation of antidepressants.

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