Self-Reported Depressive Symptom Measures: Sensitivity to Detecting Change in a Randomized, Controlled Trial of Chronically Depressed, Nonpsychotic Outpatients

• Published in: Neuropsychopharmacology (New York, N.Y.) Vol. 30; no. 2; pp. 405 - 416
• Main Authors: RUSH, A. John, TRIVEDI, Madhukar H, 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, CARMODY, Thomas J, IBRAHIM, Hisham M, MARKOWITZ, John C, KEITNER, Gabor I, KORNSTEIN, Susan G, ARNOW, Bruce, KLEIN, Daniel N, MANBER, Rachel
• Format: Journal Article
• Language: English
• Published: New York, NY Nature Publishing 01.02.2005; Nature Publishing Group
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Antidepressive Agents, Second-Generation - therapeutic use; Biological and medical sciences; Chronic Disease; Cognitive Therapy; Combined Modality Therapy; Depression; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Depressive Disorder - therapy; Female; Humans; Male; Medical sciences; Middle Aged; Mood disorders; Outpatients; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self-Assessment; Treatment Outcome; Triazoles - therapeutic use; Mood disorder; Human; Self evaluation; Psychotropic; Serotonin antagonist; Nefazodone; Psychotherapy; Depression; symptom measures; 5-HT2 Serotonine receptor; Chronic; Randomization; Sensitivity; Treatment; chronic depression; Triazole derivatives; Antidepressant agent; Piperazine derivatives; Ambulatory
• ISSN: 0893-133X; 1740-634X
• DOI: 10.1038/sj.npp.1300614

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-I) 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-I, and the 24-item Hamilton Depression Rating Scale (HDRS24) ratings were collected at baseline and at weeks 1-4, 6, 8, 10, and 12. Response was defined a priori as a > or =50% reduction in baseline total score for the IDS-SR30 or for the QIDS-SR16 or as a PGI-I score of 1 or 2 at exit. Overall response rates (LOCF) to nefazodone were 41% (IDS-SR30), 45% (QIDS-SR16), 53% (PCI-I), and 47% (HDRS17). For CBASP, response rates were 41% (IDS-SR30), 45% (QIDS-SR16), 48% (PGI-I), and 46% (HDRS17). For the combination, response rates were 68% (IDS-SR30 and QIDS-SR16), 73% (PGI-I), and 76% (HDRS17). Similarly, remission rates were comparable for nefazodone (IDS-SR30=32%, QIDS-SR16=28%, PGI-I=22%, HDRS17=30%), for CBASP (IDS-SR30=32%, QIDS-SR16=30%, PGI-I=21%, HDRS17=32%), and for the combination (IDS-SR30=52%, QIDS-SR16=50%, PGI-I=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-I, as opposed to specific item-based ratings, provide less valid findings.