RT Journal Article
SR Electronic
T1 Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1327
OP 1334
DO 10.1503/cmaj.050786
VO 173
IS 11
A1 Roger S. McIntyre
A1 Jakub Z. Konarski
A1 Deborah A. Mancini
A1 Kari A. Fulton
A1 Sagar V. Parikh
A1 Sophie Grigoriadis
A1 Larry A. Grupp
A1 David Bakish
A1 Marie-Josee Filteau
A1 Chris Gorman
A1 Charles B. Nemeroff
A1 Sidney H. Kennedy
YR 2005
UL http://www.cmaj.ca/content/173/11/1327.abstract
AB Background: Symptomatic remission is the optimal outcome in depression. A brief, validated tool for symptom measurement that can indicate when remission has occurred in mental health and primary care settings is unavailable. We evaluated a 7-item abbreviated version (HAMD-7) of the 17-item Hamilton Depression Rating Scale (HAMD-17) in a randomized controlled clinical trial of patients with major depressive disorder being cared for in primary care settings. Methods: We enrolled 454 patients across 47 primary care settings who met DSM-IV-TR criteria for a major depressive disorder. Of these, 410 patients requiring antidepressant medication were randomized to have their symptoms rated with either HAMD-7 (n = 205) or HAMD-17 (n = 205) as the primary measurement tool. The primary outcome was the proportion of patients who achieved a-priori defined responses to 8 weeks of therapy using each instrument. Results: Of the 205 participants per group, 67% of those evaluated with HAMD-7 were classified as having responded to therapy (defined as a ≥ 50% reduction from the pretreatment score), compared with 74% of those evaluated with HAMD-17 (p = 0.43). The difference between the groups' changes in scores from baseline (pretreatment) to endpoint was significant (p < 0.001), without a main effect of group (p = 0.84) or group-by-time (p = 0.83) interaction. The HAMD-7 test was brief to administer (e.g., 3–4 min for 85% of the primary care physicians evaluated), which facilitated the efficient and structured evaluation of salient depressive symptoms. Interpretation: The abbreviated HAMD-7 depression scale is equivalent to the HAMD-17 in assessing remission in patients with a major depressive disorder undergoing drug therapy.