PROBLEMDiagnosing depression in medical patients depends too heavily on clinicians' subjective evaluations; the need for objective criteria is obvious. As part of a comprehensive evaluation of depression in medical inpatients (6, ' 1, we compared the Beck Depression Inventory (BDI) ( I ) and the Hamilton Rating Scale for Depression (HRS) (3) as measures of the incidence and severity of depressions. Although both scales were devised for psychiatric patients, the possibility of extending their use to other Ss is appealing. To our knowledge, no BDI or HRS data on medical patients are available.
METHOD
Subjects.After completing a pilot study, 153 patients admitted to the University of Florida Teaching Hospital during six consecutive weeks (July 20 -August 30, 1963) were evaluated for depression. This group represented 73% of all admissions during that period. These patients are representative of a general medical population. There were 80 males and 73 females; their ages ranged from 16 to 82; the great majority were married; and they came from varied socioeconomic backgrounds. The patients' illnesses covered a broad spectrum of disease : cardiovascular 32; psychiatric 30; neurological 19; genitourinary 13; respiratory 11 ; gastrointestinal 9, etc.Procedure. Each patient was interviewed between the 24th and 72nd hours after admission by one member of the research team, who knew only the patient's age, sex, race, and marital status. Following a standard introduction, the patient was given the BDI according to Beck's instructions. The patient read the scale while the interviewer recorded the patient's rating. This was followed by a clinical interview, conducted by the same researcher, focused to obtain scores for the HRS. According to Hamilton's instructions for using one rater, we doubled the score.Four between-test comparisons were made: (1) Total BDI scores with total HRS scores, (2) BDI item scores with total BDI scores and total HRS scores, (3) HRS item scores with total HRS scores and total BDI scores, and (4) BDI item scores with HRS item scores.
RESULTS'The BDI and HRS scores were tabulated separately.
Distribution of the Total Scores.The range of BDI scores is 0 to 33 (mean 9.65, SD 6.51). Beck") divided 409 psychiatric inpatients and outpatients into four groups according to clinical ratings for depression. The means and standard deviations for his four groups are as follows: (a) no depression, N = 115, mean = 10.9, SD = 8.1; (b) mild depression, N = 127, Mean = 18.7, SD = 10.2; (c) moderate depression, N = 134, mean = 25.4, SD = 9.6; and (d) severe depression, N = 33, mean = 30.0, SD = 106. Thus, the mean found for our medical inpatients is about the same as that reported by Beck for a non-depressed psychiatric inpatient and outpatient group, and is considerably lower than the mean for the psychiatric inpatients and outpatients with depression.
