Measuring psychotic depression
Article first published online: 25 JUN 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Volume 129, Issue 3, pages 211–220, March 2014
How to Cite
Measuring psychotic depression., , , , , , , .
- Issue published online: 10 FEB 2014
- Article first published online: 25 JUN 2013
- Manuscript Accepted: 16 MAY 2013
- US Public Health Service. Grant Numbers: MH 62446, MH 62518, MH 62565, MH 62624
- National Center for Research Resources. Grant Numbers: M01-RR024153, RR000056, CTSC UL1RR024996
- National Institute of Mental Health (NIMH). Grant Numbers: P30 MH068368, MH069430, MH067710
- affective disorders;
Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD.
The psychometric properties of the rating scales were evaluated based on data from the Study of Pharmacotherapy of Psychotic Depression.
A rating scale consisting of the 6-item Hamilton melancholia subscale (HAM-D6) plus five items from the Brief Psychiatric Rating Scale (BPRS), named the HAMD-BPRS11, displayed clinical validity (Spearman's correlation coefficient between HAMD-BPRS11 and Clinical Global Impression – Severity (CGI-S) scores = 0.79–0.84), responsiveness (Spearman's correlation coefficient between change in HAMD-BPRS11 and Clinical Global Impression – Improvement (CGI-I) scores = −0.74–−0.78) and unidimensionality (Loevinger's coefficient of homogeneity = 0.41) in the evaluation of PD. The HAM-D6 fulfilled the same criteria, whereas the full 17-item Hamilton Depression Scale failed to meet criteria for unidimensionality.
Our results suggest that the HAMD-BPRS11 is a more valid measure than pure depression scales for evaluating the severity of PD.