The Bipolar Depression Rating Scale (BDRS): its development, validation and utility

Authors

  • Michael Berk,

    1. Barwon Health and the Geelong Clinic, Geelong
    2. Department of Clinical and Biomedical Sciences, University of Melbourne
    3. Orygen Research Centre, Melbourne, Victoria
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  • Gin S Malhi,

    1. CADE Clinic, Royal North Shore Hospital,
    2. Neuroscience Research Group, Psychological Medicine, Northern Clinical School, University of Sydney
    3. Mood Disorders Unit, Black Dog Institute, Prince of Wales Hospital
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  • Catherine Cahill,

    1. Mood Disorders Unit, Black Dog Institute, Prince of Wales Hospital
    2. Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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  • A Catherine Carman,

    1. Barwon Health and the Geelong Clinic, Geelong
    2. Department of Clinical and Biomedical Sciences, University of Melbourne
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  • Dusan Hadzi-Pavlovic,

    1. Mood Disorders Unit, Black Dog Institute, Prince of Wales Hospital
    2. Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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  • Mary T Hawkins,

    1. Barwon Health and the Geelong Clinic, Geelong
    2. Department of Clinical and Biomedical Sciences, University of Melbourne
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  • Mauricio Tohen,

    1. Lilly Research Laboratories, Indianapolis, IN
    2. McLean Hospital, Harvard Medical School, Belmont, MA, USA
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  • Philip B Mitchell

    1. Mood Disorders Unit, Black Dog Institute, Prince of Wales Hospital
    2. Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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  • This project was funded by an unrestricted research grant provided by Eli Lilly & Co.

Professor Michael Berk, Barwon Health and Geelong Clinic, Swanston Centre, PO Box 281, Geelong, Victoria 3220, Australia. Fax: + 61 3 5246 5165; e-mail: mikebe@barwonhealth.org.au

Abstract

Objectives:  Unipolar and bipolar depression differ neurobiologically and in clinical presentation. Existing depression rating instruments, used in bipolar depression, fail to capture the necessary phenomenological nuances, as they are based on and skewed towards the characteristics of unipolar depression. Both clinically and in research there is a growing need for a new observer-rated scale that is specifically designed to assess bipolar depression.

Methods:  An instrument reflecting the characteristics of bipolar depression was drafted by the authors, and administered to 122 participants aged 18–65 (44 males and 78 females) with a diagnosis of DSM-IV bipolar disorder, who were currently experiencing symptoms of depression. The Bipolar Depression Rating Scale (BDRS) was administered together with the Hamilton Depression Rating Scale (HAM-D), Montgomery Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS).

Results:  The BDRS has strong internal consistency (Cronbach’s alpha = 0.917), and robust correlation coefficients with the MADRS (r = 0.906) and HAM-D (r = 0.744), and the mixed subscale correlated with the YMRS (r = 0.757). Exploratory factor analysis showed a three-factor solution gave the best account of the data. These factors corresponded to depression (somatic), depression (psychological) and mixed symptom clusters.

Conclusions:  This study provides evidence for the validity of the BDRS for the measurement of depression in bipolar disorder. These results suggest good internal validity, provisional evidence of inter-rater reliability and strong correlations with other depression rating scales.

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