An examination of depression in the spouses of stroke patients.

Examined the prevalence and correlates of depression in the spouses (SPs [mean age 61.8 yrs]) of 41 stroke patients (SPTs [mean age 65.6 yrs]). SPs reported their own mood on the Beck Depression Inventory (BDI) and rated their partners' (the SPTs') mood using the Hamilton Rating Scale for Depression (HRSD). A clinician evaluated the SPTs' mood using the HRSD and their cognitive/language and physical impairments using a battery of neuropsychological tests. Results indicated that 44% of the SPs were depressed. SP depression was not correlated with the severity of the SPTs' physical, cognitive, or language impairments. However, the SPs' perception of the SPTs' mood was a better predictor of the SPs' mood than was the clinicians' evaluation of the SPTs' mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The severity of major depression and choice of treatment in primary care practice.

The Agency for Health Care Policy and Research Depression Guideline Panel recommended pharmacotherapy as the 1st-line treatment for more severely depressed primary care patients, but research supporting its recommendation has not been conducted with this population. A post hoc analysis was conducted, therefore, with data gathered in a randomized controlled trial about the relationship between initial level of depressive severity and functional ability, treatment with nortriptyline hydrochloride (NT) or interpersonal psychotherapy (IPT), and clinical course over 8 months among primary care patients experiencing major depression. Treatment type was unrelated to clinical course among more severely depressed patients (baseline 17-item Hamilton Rating Scale for Depression [HRSD] score ≥20). However, less severely depressed patients (baseline 17-item HRSD score ≤19) who were prescribed NT improved significantly more rapidly during the initial 3 months of treatment than patients provided with IPT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Zung, Beck, and Hamilton Rating Scales as measures of treatment outcome: A meta-analytic comparison.

Reviews treatment studies using the Self-Rating Depression Scale (SRDS), the Beck Depression Inventory (BDI), and the Hamilton Rating Scale for Depression (HRSD) as dependent measures. The use of meta-analytic techniques resulted in a comparison of effect sizes, indicating that contrary to some clinicians' beliefs, the SRDS and BDI showed significantly less change in depression following treatment than did the HRSD. Implications for the selection of outcome measures and for the application of meta-analytic techniques to compare dependent measures are discussed. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hamilton Rating Scale for Depression: Reliability and validity of judgments of novice raters.

Reliability studies of the Hamilton Rating Scale for Depression (HRSD) in therapy-outcome research require at least 2 clinicians. The present authors hypothesized that a less costly alternative, such as using trained undergraduates as 2nd raters, would produce results comparable to the use of 2 clinicians. Four expert raters provided criterion ratings for the HRSD on 20 depressed women. Three trained undergraduates rated the same Ss. The expert and student raters both made reliable ratings on the HRSD. Estimates of criterion validity for the student raters were also in the satisfactory range. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concurrent validity of the Millon Clinical Multiaxial Inventory depression scales.

In a sample of 95 psychiatric clinic outpatients, this investigation compared two new measures of depression (Millon Clinical Multiaxial Inventory [MCMI] Dysthymia and Major Depression subscales) with two established instruments: the Beck Depression Inventory (BDI), a self-report measure that emphasizes the cognitive-affective aspects of depression, and the Hamilton Rating Scale for Depression (HRSD), and interview measure that emphasizes somatic complaints. All measures were significantly intercorrelated. The relatively weaker relations between the HRSD and the MCMI depression subscales, which resulted because of their neglect of vegetative depressive symptoms, pose a serious problem for interpreting the meaning of the MCMI Major Depression subscale. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a history of alcohol dependence.

This study examined the effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a past history of alcohol dependence. Participants (24 women, 27 men) were randomly assigned to behavioral counseling (BC) or behavioral counseling plus cognitive-behavioral mood management training (CBT). The Hamilton -Rating Scale for Depression (HRSD; A Hamilton, 1967) was administered to assess baseline depressive symptoms. Participants who received CBT and had higher HRSD scores were more likely to achieve short-term abstinence from smoking and attend more treatment sessions than those with lower depression scores, whereas for BC participants the effect of HRSD scores was the opposite. Smokers with a history of alcohol dependence reporting high levels of depressive symptoms may benefit from a mood management intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of refractory depression with high-dose thyroxine

In an open clinical trial we investigated whether addition of supraphysiological doses of thyroxine (T4) to conventional antidepressant drugs has an antidepressant effect in therapy-resistant depressed patients. Seventeen severely ill, therapy-resistant, euthyroid patients with major depression (12 bipolar, five unipolar) were studied. The patients had been depressed for a mean of 11.5 +/- 13.8 months, despite treatment with antidepressants and, in most cases, augmentation with lithium, carbamazepine, and neuroleptics. Thyroxine was added to their antidepressant medication, and the doses were increased to a mean of 482 +/- 72 micrograms/day. The patients' scores on the Hamilton rating Scale for Depression (HRSD) declined from 26.6 +/- 4.7 prior to the addition of T4 to 11.6 +/- 6.8 at the end of week 8. Eight patients fulfilled the criteria for full remission (a 50% reduction in HRSD score and a final score of < or = 9) within 8 weeks and two others fully remitted within 12 weeks. Seven patients did not remit. The 10 remitted patients were maintained on high-dose T4 and followed up for a mean of 27.2 +/- 22.0 months. Seven of these 10 remitted patients had an excellent outcome, two had milder and shorter episodes during T4 augmentation treatment, and one failed to profit from T4 treatment during the follow-up period. Side effects were surprisingly mild, and no complications were observed at all. In conclusion, augmentation of conventional antidepressants with high-dose T4 proved to have excellent antidepressant effects in approximately 50% of severely therapy-resistant depressed patients.     

Classifying college students as depressed or nondepressed using the Beck Depression Inventory: An empirical analysis.

In Study 1, the classification of 150 college students as nondepressed or mildly or moderately depressed was compared using Beck Depression Inventory (BDI) scores obtained on 2 occasions, either on the same day or 1 wk later. Whereas the overall test–retest reliability coefficients were acceptable, particularly when both administrations occurred on the same day, the consistency of classification of Ss into the mild and moderate levels of depression was poor. In an attempt to determine the factors contributing to the poor classification consistency, a 2nd study with 207 Ss compared the effect of exposure to the BDI on subsequent BDI responses. Ss who completed the BDI on 2 occasions showed significantly lower BDI scores compared to Ss exposed to an alternate depression inventory (the Self-Rating Depression Scale [SRDS]) or no prior questionnaire. In addition, a large percentage of Ss classified as moderately depressed following the initial BDI administration failed to be classified within the moderate categories on retesting the same day. Ss tested using the SRDS maintained the same depression classification when retested on the BDI. Item analyses failed to reveal significantly different amounts of change among individual BDI items. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magnetic resonance imaging correlates of depression in early- and late-onset Alzheimer''s disease

Even today psychotic depression is connected to a lot of unanswered questions. A self-questionnaire (BFD) was developed in order to evaluate cognitions corresponding to mood congruent depressive delusions. They were assumed to indicate psychotic depression and to be related to severity of the depressive syndrome. 42 depressed inpatients were examined by the BFD, the Hamilton Depression Scale (HAMD) and the Beck Depression Inventory (BDI). BFD scores were found increased in psychotic depression (p = 0.009) and correlated to BDI scores (p = 0.002). 19 re-examined patients showed a significant improvement in HAMD and BDI scores but not concerning the delusion indicating cognitions (BFD), which were significantly correlated to suicidality items of BDI and HAMD (p = 0.005). The results prove the delusion indicating nature of cognitions measured by the BFD and their correlation to severe depression. Differences in treatment response are indicated and persisting or increasing BFD scores seem to be accompanied by more severe suicidal tendency.     

The measurement of pessimism: The Hopelessness Scale.

Administered a scale designed to quantify hopelessness to 294 hospitalized suicide attempters, 23 general medical outpatients, 62 additional hospitalized suicide attempters, and 59 depressed psychiatric patients. The scale had a Kuder-Richardson-20 internal consistency coefficient of .93 and correlated well with the Stuart Future Test (SFT) and the pessimism item of the Beck Depression Inventory (BDI; .60 and .63, respectively). The scale was also sensitive to changes in the patient's state of depression over time, as evidenced by a correlation of .49 with change scores on the SFT and .49 with the change scores on the BDI. Findings also indicate that depressed patients have an unrealistically negative attitude toward the future and that seriousness of suicidal intent is more highly correlated with negative expectancies than with depression. A principal-components factor analysis revealed 3 factors which tapped affective, motivational, and cognitive aspects of hopelessness. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Methodological considerations in the assessment of depression in alcoholics.

Depression in 185 male (mean age 38.8 yrs) and 65 female (mean age 37.4 yrs) alcoholics was diagnosed by the DSM-III, the MMPI D scale, and the Beck Depression Inventory (BDI). The number of Ss diagnosed as depressed varied considerably according to the method used. The MMPI D scale classified the largest number of alcoholics as depressed (62%), followed by the BDI (54%), and the DSM-III (27%). The MMPI and the BDI were highly correlated, but both showed only a modest relationship with the DSM-III. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prediction of suicidal intent in depressed patients

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in-patients. A total of 338 adult depressed psychiatric in-patients were examined and classified according to DSM-III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self-Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self-rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self-esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.     

Synaptosomal uptake of alpha-ketoglutarate and glutamine in thioacetamide-induced hepatic encephalopathy in rats

The Hospital Anxiety and Depression Scale (HAD) was evaluated in a Swedish population sample. The purpose of the study was to compare the HAD with the Beck Depression Inventory (BDI) and Spielberger's State Trait Anxiety Inventory (STAI). A secondary aim was to examine the factor structure of the HAD. The results indicated that the factor structure was quite strong, consistently showing two factors in the whole sample as well as in different subsamples. The correlations between the total HAD scale and BDI and STAI, respectively, were stronger than those obtained using the different subscales of the HAD (the anxiety and depression subscales). As expected, there was also a stronger correlation between the HAD and the non-physical items of the BDI. It was somewhat surprising that the factor analyses were consistently extracting two factors, 'depression' and 'anxiety', while on the other hand both BDI and STAI tended to correlate more strongly with the total HAD score than with the specific depression and anxiety HAD subscales. Nevertheless, the HAD appeared to be (as was indeed originally intended) a useful clinical indicator of the possibility of depression and clinical anxiety.     

A structured interview version of the Hamilton Rating Scale for Depression: Reliability and validity.

Reliability and validity data are provided for pre- and posttreatment administrations of a structured interview version of the Hamilton Rating Scale for Depression (HRSD) integrated with the National Institute of Mental Health Diagnostic Interview Schedule (DIS). Ss were 70 adult patients requesting therapy for depression. Results indicate excellent agreement between DIS–HRSD ratings made by graduate students and psychiatrist-administered HRSD ratings. The DIS–HRSD exhibited a pattern of correlation with other scales of depression similar to that of the HRSD, thus supporting the validity of the new scale. Intraclass correlations and concurrent validity estimates obtained from analyzing data separately for pre- and posttest administrations were consistently lower than those obtained from the whole sample, suggesting that methodological shortcomings in prior psychometric studies of the HRSD may have spuriously inflated the obtained results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical significance of psychotherapy for unipolar depression: A meta-analytic approach to social comparison.

[Correction Notice: An erratum for this article was reported in Vol 55(3) of Journal of Consulting and Clinical Psychology (see record 2008-10745-001). The data presented in Table 2 were incorrect because a row and a column were inadvertently omitted. The corrected Table 2 appears in the erratum.] This study used meta-analysis to study the clinical significance of psychotherapy for symptoms of unipolar depression. The following questions were addressed: How similar is the posttherapy adjustment of depressed adults to that of nondepressed adults? Is this adjustment maintained at follow-up? What dimensions of treatment, therapists, or design are associated with clinical significance? Using the Beck Depression Inventory (BDI), we calculated composite BDI norms from 28 published studies. Sixty effect sizes (from 31 outcome studies utilizing the BDI) were calculated. The results indicated that psychotherapy produces outcomes that have moderate clinical significance and that are well-maintained at follow-up, that individual therapy is associated with greater clinical significance than group treatment, and that type of therapy is not related to improvement. Alternative approaches for operationalizing clinical significance as the return of individuals to normal levels of functioning are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Induction of depressive affect after prolonged exposure to a mildly depressed individual.

Administered the Beck Depression Inventory (BDI) to 44 undergraduate roommate pairs during the 1st, 5th, and 11th wks of a 13-wk quarter. 22 pairs contained mildly or moderately depressed Ss; the other 22 pairs contained only nondepressed Ss (NSs). These mildly or moderately depressed Ss included 8 unremitted depressives and 14 transient-remitted depressives. Analyses indicated that after 5 wks and 11 wks of living together, the roommates of unremitted depressives had significantly higher BDI scores than NSs. Moreover, their BDI scores at 5 and 11 wks were significantly higher than they were at the 1st wk. Results also show that at 5 and 11 wks the BDI scores of the roommates of transient-remitted persons were significantly higher than scores of NSs. Possible causes for this induction of depressive affect include direct induction stemming from day-to-day contact, a modeling process, or increased dysphoria associated with an unhappy roommate relationship. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of competence inventory for college men and evaluation of relationships between competence and depression.

Hypothesized that deficits in interpersonal and problem-solving skills are significantly related to nonclinical depression. A behavioral role-playing measure of competence in male college students was developed via a procedure introduced by M. R. Goldfried and T. J. D'Zurilla (1969). This new measure, the Problem Inventory for College Students (PICS), was administered to 92 undergraduate males to assess the relationships between competence and depression. Depression was assessed in 2 ways: The current presence or absence of a nonclinical state of depression was measured by the Beck Depression Inventory (BDI) and the tendency toward experiencing frequent nonclinical depressions was measured by self-report. Ss who were currently depressed according to their BDI scores had significantly lower competence scores on the PICS than nondepressed Ss. Ss who reported experiencing frequent depressions did not earn significantly different competence scores on the PICS than Ss who reported seldom experiencing depressions. Results partially support the hypothesized relationship between competence and depression. The association between the PICS and the BDI indicates that incompetence is a concomitant of depression, if not a precursor. Results are a 1st step toward establishing the construct validity of the PICS as a competence measure for college males. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a preventive intervention for perinatal depression in high-risk Latinas.

Objective: A randomized controlled trial was conducted to evaluate the efficacy of a cognitive–behavioral (CBT) intervention to prevent perinatal depression in high-risk Latinas. Method: A sample of 217 participants, predominantly low-income Central American immigrants who met demographic and depression risk criteria, were randomized into usual care (UC; n = 105) or an 8-week CBT group intervention during pregnancy and 3 individual booster sessions during postpartum (n = 112). Participants completed measures assessing depressive symptoms (Center for Epidemiological Studies Depression Scale at baseline; Beck Depression Inventory, Second Edition [BDI–II]) and major depressive episodes (Mood Screener) at 5 time points throughout the perinatal period. Results: Intent-to-treat analyses indicated that intervention participants had significantly lower depressive symptoms and fewer cases of moderate depression (BDI–II ≥ 20) at Time 2 than UC participants. These effects were stronger for women who fully participated in the intervention (≥4 classes). The cumulative incidence of major depressive episodes was not significantly different between the intervention (7.8%) and UC (9.6%) groups. Conclusions: A CBT intervention for low-income, high-risk Latinas reduced depressive symptoms during pregnancy but not during the postpartum period. Low levels of depressive symptoms and lower than expected rates of clinical depression in both groups may partially be due to methodological issues. As perinatal depression is a significant public health problem, more work is needed to prevent perinatal depression in low-income, ethnically diverse women. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Beck Depression Inventory and Research Diagnostic Criteria: Congruence in an Older Population.

This study examined the congruence between conventional cutoff scores on the Beck Depression Inventory (BDI) and selected diagnostic classifications of the Research Diagnostic Criteria in a sample of 102 elders seeking psychological treatment. Only 16.67% were misclassified by customary BDI cutoff scores. Minor Depressive Disorders were less clearly identified than Major Depressive Disorders or nondepressed status. Similar results were obtained in a second sample of elders not seeking treatment. Findings support the utility of the BDI as a screening instrument for identification of clinically depressed elders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Varicella vaccine in immunocompromised patients

OBJECTIVE: To determine the prevalence of depressive symptoms and their relationship to disability in older low vision patients. DESIGN: Panel study with 2-year follow-up. PARTICIPANTS: Community-residing older people (N = 31). MEASUREMENTS: Geriatric Depression Scale, Community Disability Scale, and Snellen visual acuity. RESULTS: Twelve of 31 patients (38.7%) had GDS scores > or = 11 at baseline. Two years later, 10 of these 12 patients remained depressed, and three of the 19 (15.8%) previously nondepressed patients had become depressed. Depressed patients tended to be more disabled functionally than nondepressed patients at follow-up. The correlation of disability with depression and with vision were examined for the entire sample and revealed a strong correlation between disability and depression (r = .40; P = .013) compared with that of disability and vision (r = .34; P = .032) at baseline and at follow-up: depression (r = .68; P = .001), vision (r = .45; P = .006). There was no significant correlation between depression and vision at baseline (r = .06; P = .383), but there was a trend toward correlation at follow-up (r = .28; P = .067). CONCLUSION: Depressive symptoms are prevalent and persistent among low vision patients and appear more highly related to disability than is vision. The frequent occurrence of depression and the availability of effective treatment argue for its recognition and treatment as possible ways to reduce disability in older persons with low vision.