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- Title
Self-Reported Depressive Symptom Measures: Sensitivity to Detecting Change in a Randomized, Controlled Trial of Chronically Depressed, Nonpsychotic Outpatients.
- Authors
Rush, A. John; Trivedi, Madhukar H.; Carmody, Thomas J.; Ibrahim, Hisham M.; Markowitz, John C.; Keitner, Gabor I.; Kornstein, Susan G.; Arnow, Bruce; Klein, Daniel N.; Manber, Rachel; Dunner, David L.; Gelenberg, Alan J.; Kocsis, James H.; Nemeroff, Charles B.; Fawcett, Jan; Thase, Michael E.; Russell, James M.; Jody, Darlene N.; Borian, Frances E.; Keller, Martin B.
- Abstract
This study evaluated and compared the performance of three self-report measures: (1) 30-item Inventory of Depressive Symptomatology-Self-Report (IDS-SR30); (2) 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16); and (3) Patient Global Impression-Improvement (PGI-1) in assessing clinical outcomes in depressed patients during a 12-week, acute phase, randomized, controlled trial comparing nefazodone, cognitive-behavioral analysis system of psychotherapy (CBASP), and the combination in the treatment of chronic depression. The IDS-SR30, QIDS-SR16, PGI-1, and the 24-item Hamilton Depression Rating Scale (HDRS24) ratings were collected at baseline and at weeks 14, 6, 8, 10, and 12. Response was defined a priori as a ≥50% reduction in baseline total score for the IDS-SR30 or for the QIDS-SR16 or as a PGI-1 score of 1 or 2 at exit. Overall response rates (LOCF) to nefazodone were 41% (IDS-SR30), 45% (QIDS-SR16), 53% (PCI-1), and 47% (HDRS17). For CBASP, response rates were 41% (IDS-SR30), 45% (QIDS-SR16), 48% (PGI-1), and 46% (HDRS17). For the combination, response rates were 68% (IDS-SR30 and QIDS-SR16), 73% (PGI-1), and 76% (HDRS17). Similarly, remission rates were comparable for nefazodone (IDS-SR30 = 32%, QIDS-SR16 = 28%, PGI1 = 22%, HDRS17 = 30%), for CBASP (IDS-SR30 = 32%, QIDS-SR16 = 30%, PGI-1 = 21%, HDRS17 = 32%), and for the combination (IDSSR30=52%, QIDS-SR16=50%, PGI-1=25%, HDRS17=49%). Both the IDS-SR30 and QIDS-SR16 closely mirrored and confirmed findings based on the HDRS24. These findings raise the possibility that these two self-reports could provide cost- and time-efficient substitutes for clinician ratings in treatment trials of outpatients with nonpsychotic MDD without cognitive impairment. Global patient ratings such as the PGI-1, as opposed to specific item-based ratings, provide less valid findings.
- Subjects
DIAGNOSIS of mental depression; OUTPATIENT medical care; PATIENTS; SYMPTOMS; CLINICAL trials; ANTIPSYCHOTIC agents
- Publication
Neuropsychopharmacology, 2005, Vol 30, Issue 2, p405
- ISSN
0893-133X
- Publication type
Article
- DOI
10.1038/sj.npp.1300614