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- Title
Measuring depressive symptoms in the naturalistic primary-care setting.
- Authors
McIntyre, R. S.; Konarski, J. Z.; Kennedy, S. H.; Dickens, S. E.; Bagby, R. M.
- Abstract
Background: The majority of individuals with major depressive disorder are diagnosed and treated in the primary-care setting. A quantifiable critical objective in the management of depression is to achieve and sustain full symptomatic remission. The HAMD-7 is a depression metric validated in both tertiary and primary-care settings. Methods: Herein, we further characterise the psychometric properties of the HAMD-7 in depressed patients treated in primary-care settings. Several cut-scores were evaluated for maximum agreement; diagnostic efficacy statistics with the original HAMD-7 items were also evaluated. We compared performance of the HAMD-7 in primary care to a previously characterised tertiary sample. Results: The depressive symptoms most frequently endorsed (≥ 70%) and most sensitive to change during antidepressant treatment in depressed primary-care patients were depressed mood, guilt, work and activities, psychic and somatic anxiety and fatigue. Limitations: This is a post hoc analysis of a primary-care database; assumptions regarding the definition of symptomatic remission in depression affect interpretation. Conclusion: Measurement-based care with the HAMD-7 quantifies the severity of commonly reported depressive items and their responsivity to treatment. The HAMD-7, inclusive of the suicide item, is capable of tracking symptom progress, with a validated remission cut-score.
- Publication
International Journal of Clinical Practice, 2007, Vol 61, Issue 8, p1278
- ISSN
1368-5031
- Publication type
Article
- DOI
10.1111/j.1742-1241.2007.01448.x