The WSAS is a simple, reliable and valid measure of impaired functioning. It is a sensitive and useful outcome measure offering the potential for readily interpretable comparisons across studies and disorders.
In nonpsychotic MDD outpatients without overt cognitive impairment, clinician assessment of depression severity using either the QIDS-C16 or HRSD17 may be successfully replaced by either the self-report or IVR version of the QIDS.
Efforts to develop more effective depression treatments are limited by assessment methods that rely on patient-reported or clinician judgments of symptom severity. Depression also affects speech. Research suggests several objective voice acoustic measures affected by depression can be obtained reliably over the telephone. Thirty-five physician-referred patients beginning treatment for depression were assessed weekly, using standard depression severity measures, during a six-week observational study. Speech samples were also obtained over the telephone each week using an IVR system to automate data collection. Several voice acoustic measures correlated significantly with depression severity. Patients responding to treatment had significantly greater pitch variability, paused less while speaking, and spoke faster than at baseline. Patients not responding to treatment did not show similar changes. Telephone standardization for obtaining voice data was identified as a critical factor influencing the reliability and quality of speech data. This study replicates and extends previous research with a larger sample of patients assessing clinical change associated with treatment. The feasibility of obtaining voice acoustic measures reflecting depression severity and response to treatment using computer-automated telephone data collection techniques is also established. Insight and guidance for future research needs are also identified.
Background
Valid, reliable biomarkers of depression severity and treatment response would provide new targets for clinical research. Noticeable differences in speech production between depressed and nondepressed patients have been suggested as a potential biomarker.
Methods
One hundred and five adults with Major Depression were recruited into a four-week, randomized, double-blind, placebo-controlled research methodology study. An exploratory objective of the study was to evaluate the generalizability and repeatability of prior study results indicating vocal acoustic properties in speech may serve as biomarkers for depression severity and response to treatment. Speech samples, collected at baseline and study end-point using an automated telephone system, were analyzed as a function of clinician-rated and patient-reported measures of depression severity and treatment response.
Results
Regression models of speech pattern changes associated with clinical outcomes in the prior study were found to be reliable and significant predictors of outcome in the current study despite differences in the methodological design and implementation of the two studies. Results of the current study replicate and support findings from the prior study. Clinical changes in depressive symptoms among patients responding to the treatments provided also reflected significant differences in speech production patterns. Depressed patients who did not improve clinically showed smaller vocal acoustic changes and/or changes that were directionally opposite to treatment responders.
Conclusions
This study supports the feasibility and validity of obtaining clinically important, biologically-based vocal acoustic measures of depression severity and treatment response using an automated telephone system. National Institutes of Health Clinical Trials Registry: http://clinicaltrials.gov Identifier: NCT00406952.
The present study sought to develop updated risk categories and recidivism estimates for the Violence Risk Scale-Sexual Offense version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon, 2003-2017), a sexual offender risk assessment and treatment planning tool. The overarching purpose was to increase the clarity and accuracy of communicating risk assessment information that includes a systematic incorporation of new information (i.e., change) to modify risk estimates. Four treated samples of sexual offenders with VRS-SO pretreatment, posttreatment, and Static-99R ratings were combined with a minimum follow-up period of 10-years postrelease (N = 913). Logistic regression was used to model 5- and 10-year sexual and violent (including sexual) recidivism estimates across 6 different regression models employing specific risk and change score information from the VRS-SO and/or Static-99R. A rationale is presented for clinical applications of select models and the necessity of controlling for baseline risk when utilizing change information across repeated assessments. Information concerning relative risk (percentiles) and absolute risk (recidivism estimates) is integrated with common risk assessment language guidelines to generate new risk categories for the VRS-SO. Guidelines for model selection and forensic clinical application of the risk estimates are discussed. (PsycINFO Database Record
Patients reporting lifetime suicidal ideation with intent to act and/or prior suicidal behavior at baseline are 4 to 9 times more likely to prospectively report suicidal behavior during study participation.
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