REMISSION CRITERIA FOR DEPRESSION WHEN USING SHORT VERSIONS OF THE HAMILTON DEPRESSION RATING SCALE (HDRS)
Author(s)
Ballesteros J1, Guemes I1, Bobes J2, Bulbena A3, Luque A4, Dal-Re R5, Ibarra N61The University of the Basque Country, Leioa, Vizcaya, Spain; 2 University of Oviedo, Oviedo, Oviedo, Spain; 3 Hospital del Mar, Barcelona, Barcelona, Spain; 4 AstraZeneca, Madrid, Madrid, Spain; 5 GlaxoSmithKline, Madrid, Madrid, Spain; 6 Maria Josefa Recio Foundation, Bilbao, Vizcaya, Spain
OBJECTIVES: To define criteria for symptoms remission in depression for reduced versions of the HDRS. METHODS: The discriminative validity of the HDRS (HDRS-21 and 17 items) and its shorter scales [Bech Melancholia Scale (BMS-6); Maier & Philips Severity Scale (MPSS-6); Gibbons et al Depression Scale (GDS-8); Evans et al Depression Scale (EDS-6)], was assessed against the Clinical Global Impression of severity (CGI) in a Spanish multicenter study. The study included 168 depressive patients in ambulatory care. Of these, 118 patients were considered as clinically unstable (either because of presenting a new/recurrent disease episode or because of needing an adjustment/change of treatment). After six weeks, those patients were reassessed by the HDRS and the CGI. The best cut-off points to discriminate the criterion of clinical remission (CGI score = 1) were found by using Receiver Operating Characteristic analyses (ROC). The accuracy of the different versions was assessed by analysing the area under the ROC curves (AUC). RESULTS: All versions discriminated at baseline the severity of depression according to the CGI criterion (all p-values <0.005 by oneway ANOVA corrected for multiple comparisons). Also, all versions discriminated the severity of depression (remission versus no remission) at six weeks of follow-up (all p-values <0.0001 by t-test analyses). The ROC analyses suggested the following cut-off points to identify remission criteria in our sample (HDRS-21:
Conference/Value in Health Info
2005-11, ISPOR Europe 2005, Florence, Italy
Value in Health, Vol. 8, No.6 (November/December 2005)
Code
PMH41
Topic
Medical Technologies
Topic Subcategory
Diagnostics & Imaging
Disease
Mental Health