The challenge of measurement in psychiatry: the lifetime accomplishments of Per Bech (1942-2018)

Patierno

Fava

et al. 2020

Psychother Psychosom

Self Cite

149

101

The format of the original Hamilton Rating Scale for Depression (HAM-D) was unstructured: only general instructions were provided for rating individual items. Over the years, a number of modified versions of the HAM-D have been proposed. They differ not only in the number of items, but also in modalities of administration. Structured versions, including item definitions, anchor points and semi-structured or structured interview questions, were developed. This comprehensive review was conducted to examine the clinimetric properties of the different versions of the HAM-D. The aim was to identify the HAM-D versions that best display the clinimetric properties of reliability, validity, and sensitivity to change. The search was conducted on MEDLINE, Scopus, Web of Science, and PubMed, and yielded a total of 35,473 citations, but only the most representative studies were in-cluded. The structured versions of the HAM-D were found to display the highest inter-rater and test-retest reliability. The Clinical Interview for Depression and the 6-item HAM-D showed the highest sensitivity in differentiating active treatment from placebo. The findings indicate that the HAM-D is a valid and sensitive clinimetric index, which should not be discarded in view of obsolete and not clinically relevant psychometric criteria. The HAM-D, however, requires an informed use: unstructured forms should be avoided and the type of HAM-D version that is selected should be specified in the registration of the study protocol and in the methods of the trial. scale exceeds 21,000 on Scopus. Hamilton himself recommended, however, to use only the first 17 items of the HAM-D 21 since the last 4 symptoms (i.e., diurnal variation, depersonalization/derealization, paranoid and obsessional/compulsive symptoms) were either not considered part of the disease, or they were relatively uncommon, or they were not considered features related to depression severity [2,3]. Over the years, a number of modifications of the scale have been proposed and several versions of the HAM-D have been developed and come into use [4,5].

Section: From Psychometrics To Clinimetricsmentioning

confidence: 99%

The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions

Patierno

Fava

et al. 2020

Psychother Psychosom

Self Cite

149

101

“…Future studies, making use of item response theory (IRT) models (i.e. Rasch and Mokken analyses), are needed to examine the scalability (Bech, 2016; Fava et al, 2018; Fleck et al, 2019) of the ES. Fourth, only self‐reported measures were used, precluding the evaluation of the clinical validity of the ES.…”

Section: Discussionmentioning

confidence: 99%

“…Future studies, making use of item response theory (IRT) models (i.e. Rasch and Mokken analyses), are needed to examine the scalability (Bech, 2016;Fava et al, 2018;Fleck et al, 2019) Well-Being Index, the WHO-5 (Topp et al, 2015), and the Positive Mental Health Scale, the PMH (Lukat et al, 2016), are needed to further evaluate the concurrent validity of the Chinese version of the ES.…”

Section: Limitationsmentioning

confidence: 99%

Clinimetric properties of the Chinese version of the Euthymia Scale

Zhang

Wang

Clin Psychology and Psychoth

et al. 2021

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The present study was conducted to primarily evaluate the clinimetric sensitivity of the Chinese version of the Euthymia Scale (ES), testing whether this measure discriminated between different groups of patients. Concurrent validity, a clinimetric property that refers to the assessment of the extent to which the rating scale under examination correlates with another related, previously validated, assessment instrument, was also tested investigating whether the ES significantly and negatively correlated with measures of depression and anxiety. A cross‐sectional study was conducted. A total of 295 inpatients were recruited from different medical settings and included in this study. In addition to the ES, participants completed the PHQ‐9 for the assessment of depression and the GAD‐7 for the evaluation of symptoms of generalized anxiety. The clinimetric sensitivity of the ES was evaluated using the Mann–Whitney test and the Kruskal–Wallis analysis of variance, whereas the concurrent validity was tested via Spearman's correlation coefficients. The ES total score and its subscales of psychological flexibility and well‐being discriminated between different groups of inpatients and sensitively differentiated depressed from non‐depressed patients. Negative and statistically significant correlations between the ES and measures of depression and anxiety were found. Findings of the present study indicate that the Chinese version of the ES is a valid and sensitive clinimetric index that can be used not only to differentiate depressed from non‐depressed patients but also as a screening measure to detect vulnerability to depression in a wide range of medical patients.

“…50 In the psychometric model, a statistically significant correlation between items is often required to increase the internal reliability of the rating scale. 51,52 However, as has been widely demonstrated, the redundant nature of items may increase the internal consistency of the rating scale but is likely to decrease its sensitivity. 23,26,28,51-53 This is the main reason why previous studies 10,11,54 suggested using the SCL-90-R subscales in conjunction with highly sensitive clinician-rated scales such as the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), 55 which was found to be a valid measure of symptoms of psychological distress (i.e., demoralization) in patients with PD.…”

Section: Discussionmentioning

confidence: 99%

“…51,52 However, as has been widely demonstrated, the redundant nature of items may increase the internal consistency of the rating scale but is likely to decrease its sensitivity. 23,26,28,51-53 This is the main reason why previous studies 10,11,54 suggested using the SCL-90-R subscales in conjunction with highly sensitive clinician-rated scales such as the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), 55 which was found to be a valid measure of symptoms of psychological distress (i.e., demoralization) in patients with PD. 56-58 Findings of the present study also indicate that the SCL-90-R subscales of anxiety, depression, cognitive performance deficits, interpersonal sensitivity, and psychoticism included misfitting items.…”

Section: Discussionmentioning

confidence: 99%

The Hopkins Symptom Checklist (SCL-90-R): A Patient-Reported Outcome Measure in Parkinson’s Disease

J Geriatr Psychiatry Neurol

Christensen

Patierno

et al. 2021

Self Cite

Objective: This is the first study applying Clinimetric Patient-Reported Outcome Measures (CLIPROM) criteria to evaluate the construct validity, sensitivity, and clinical utility of the SCL-90-R in patients with Parkinson’s disease (PD). Methods: A Rasch analysis was conducted using a sample of 488 PD outpatients. Results: Testing for dimensionality revealed that less than 5% of t-tests were significant, indicating that the SCL-90-R subscales entailed the property of construct validity. As to the total score, a Person Separation Reliability Index of .96 was found. Conclusions: The SCL-90-R total score is a sensitive screening measure that can be used not only to differentiate healthy stress reactions from symptoms of psychological distress but also to detect PD patients with an increased risk for psychiatric complications. As to the subscales, the brief versions that did not include misfitting items should be used to assess the severity of specific symptoms of psychological distress affecting PD patients.