The time has come to stop rotations for the identification of structures in the Hamilton Depression Scale (HAM-D₁₇)

• Published in: Revista brasileira de psiquiatria Vol. 35; no. 4; pp. 360 - 363
• Main Authors: Bech, Per, Csillag, Claudio, Hellström, Lone, Fleck, Marcelo Pio de Almeida
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Associação Brasileira de Psiquiatria 01.12.2013; Associação Brasileira de Psiquiatria (ABP)
• Subjects: Depression - diagnosis; Depression - psychology; Depressive Disorder - diagnosis; Depressive Disorder - psychology; exploratory factor analysis; Factor Analysis, Statistical; Female; Hamilton Depression Scale; Humans; Male; Middle Aged; Principal Component Analysis; Psychiatric Status Rating Scales; PSYCHIATRY; exploratory factor analysis; Hamilton Depression Scale; principal component analysis
• ISSN: 1516-4446; 1809-452X; 1809-452X; 1516-4446
• DOI: 10.1590/1516-4446-2013-1116

To use principal component analysis (PCA) to test the hypothesis that the items of the Hamilton Depression Scale (HAM-D₁₇) have been selected to reflect depression disability, whereas some of the items are specific for sub-typing depression into typical vs. atypical depression. Our previous study using exploratory factor analysis on HAM-D₁₇ has been re-analyzed with PCA and the results have been compared to a dataset from another randomized prospective study. PCA showed that the first principal component was a general factor covering depression disability with factor loadings very similar to those obtained in the STAR*D study. The second principal component was a bi-directional factor contrasting typical vs. atypical depression symptoms. Varimax rotation gave no new insight into the factor structure of HAM-D₁₇. With scales like the HAM-D₁₇, it is very important to make a proper clinical interpretation of the PCA before attempting any form of exploratory factor analysis. For the HAM-D₁₇, our results indicate that profile scores are needed because the total score of all 17 items in the HAM-D₁₇ does not give sufficient information.