Are self-report scales as effective as clinician rating scales in measuring treatment response in routine clinical practice?

• Published in: Journal of affective disorders Vol. 225; pp. 449 - 452
• Main Authors: Zimmerman, Mark, Walsh, Emily, Friedman, Michael, Boerescu, Daniela A., Attiullah, Naureen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2018
• Subjects: Adult; Clinician rating; CUDOS; Depression; Depression - diagnosis; Depression - psychology; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; Diagnostic and Statistical Manual of Mental Disorders; Female; Hamilton; Humans; Male; Middle Aged; Outcome; Outcome Assessment (Health Care); Outpatients; Patient Health Questionnaire; PHQ-9; Psychiatric Status Rating Scales - standards; Psychometrics - statistics & numerical data; QIDS; Scale; Self Report; CUDOS; QIDS; Clinician rating; Outcome; Hamilton; Depression; Scale; PHQ-9; Self-report
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2017.08.024

Recent treatment guidelines have suggested that outcome should be measured in routine clinical practice. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared three self-report scales of depressive symptoms and the two most widely used clinician administered scales in treatment studies in their sensitivity to change and evaluation of treatment response in depressed patients treated in routine practice. At baseline and 4-month follow-up 153 depressed outpatients with DSM-IV MDD completed the Clinically Useful Depression Outcome Scale (CUDOS), Quick Inventory of Depressive Symptomatology—Self-report version (QIDS-SR), and Patient Health Questionnaire (PHQ-9). The patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD) and the Montgomery-Asberg Depression Rating Scale (MADRS). On each scale treatment response was defined as a 50% or greater reduction in scores from baseline. While there were some differences in the percentage of patients considered to be responders on the different scales, a large effect size was found for each scale, with little variability amongst the scales. The level of agreement between the three self-report scales and the clinician rating scales was approximately the same The present study was conducted in a single clinical practice in which the majority of the patients were white, female, and had health insurance. When measuring outcome in clinical practice the magnitude of change in depressive symptoms is as great on self-report scales as on clinician rating scales. •Recent treatment guidelines have suggested that outcome should be measured in routine clinical practice.•We compared 3 self-report and 2 clinician scales of depressive symptoms in evaluating outcome in routine practice.•The magnitude of change of depressive symptoms is as great on self-report scales as on clinician rating scales.