Performance of the Hamilton Depression Rating Scale in depressed patients in the United Arab Emirates

Abstract

Cross-cultural variation in the frequencies and modes of expression of depressive symptoms may influence the validity of depression rating scales. The most widely used instrument for this purpose, namely Hamilton's Depression Rating Scale (HDRS), has not been systematically evaluated in Arab countries. This study evaluates the face validity of the HDRS-21 by studying symptom frequencies, factor structure and symptom clusters in 100 UAE depressed patients. Concurrent validity is tested by comparing total HDRS scores with global estimates of severity made by clinicians, admission status, impairment of social and occupational functioning, and the endogenicity score of the Newcastle (NC) Diagnostic Index. Total HDRS scores show highly significant agreement with three independent measures of severity of depression. Rank orders of the most and least frequent symptoms are consistent with studies of similar design. Marked differences lie in more retardation and somatization and fewer cognitive components in the present study. Principal-component analysis confirmed the heterogeneous structure of the scale, separating a group of core depressive symptoms, and endogenous, somatization, anxiety and psychotic symptom components. The internal consistency (reliability) of the whole scale is moderate, and improves in the core symptom factor. The main conclusion is that the HDRS is sensitive to severity of depression in the UAE culture. However, it measures heterogeneous aspects, and its internal consistency suffers as a result. High levels of retardation and somatization contribute significantly to the total score in socially developing communities.

Family History, Life Events and the Factorial Structure of Depression in a Nigerian Sample of Inpatients

“…Across cultures, recent factor analytical studies of the HDRS [17,18] have yielded similar factors as the earlier studies [19,20], namely, general depression, insomnia, endogenous and anxiety. In view of the fact that these factors do not cover the universe of symptoms and dimensions related to depression (e.g., depression with psychotic symptoms), it has been argued that a factor analytical study ideally should include several relevant instruments, each spanning all or parts of the hypothesized symptom universe [21,22].…”

“…Factor 4, loading highly on agitation and hostility, reminds us of the symptoms by which clinicians diagnose 'agitated depression', and also connotes an anxiety dimension. In Ohaeri/Otote [20], UAE [18], France [17], UK [20], London moiety of US/UK project [20] Current study Binitie (Nigeria, 1975 order words this later analysis was able to sharply focus psychotic depression, severe depression and endogenous and agitation dimensions in depression. In table 5, the HDRS factors of depression are compared across cultures and, in the case of Nigeria, across time.…”

“…The objectives of the study were: (1) to compare the prevalence of a family history of mental disorders among inpatients with the subcategories of depression as in the ICD-10; (2) to compare the life event scores of these subcategories in patients; (3) to examine whether combining the items of the 23-item HDRS [19] and Brief Psychiatric Rating Scale (BPRS) [29] would yield factors that are more representative of the dimensions of depression, and (4) to compare the factors of depression from HDRS with those of the 1975 Nigerian report [20], and similar reports from the United Arab Emirates (UAE) [18] and developed countries [17,23].…”

Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers

“…5,6,20,42 In these studies, caregivers who experienced these difficulties were found to have higher mortality rate than the noncaregiving controls. Report also revealed that only 56% of the caregivers have the knowledge on their risk for depression.…”

“…41 Caregivers for patients undergoing dialysis also experience depression, anxiety, fatigue, social isolation, relationship strains, physical, emotional, and financial strain. 5,6,15,20,21,42 These caregivers who are expected to provide complex technical regimens experience stress from the added responsibility of taking over the medical treatments, dietary requirements, clinical appointments, and psychosocial issues. 16,17,19 Despite these burden experienced by caregivers, they have not been provided the needed management to control depression and other impact of the caregiving burden.…”