Standardized clinical outcome rating scale for depression for use in clinical practice

Abstract

The integration of research into clinical practice to conduct effectiveness studies faces multiple obstacles. One obstacle is the burden of completing research measures of outcome. A simple, reliable, and valid measure that could be rated at every visit, incorporated into a clinician's progress note, and reflect the DSM-IV definition of a major depressive episode (including partial and full remission from the episode) would enhance the ability to conduct effectiveness research. The goal of the present study was to examine the reliability and validity of such a measure. Three hundred and three psychiatric outpatients who were being treated for a DSM-IV major depressive episode were rated on the Standardized Clinical Outcome Rating for Depression (SCOR-D), 17-item Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning. We examined the correlation between the SCOR-D and the other measures, and conducted an analyses of variance to compare mean values on these measures for each rating point on the SCOR-D. The inter-rater reliability of the SCOR-D dimensional ratings and categorical determination of remission were high. The SCOR-D was highly correlated with the other scales, and there were significant differences on the other measures of depression severity between each adjacent rating level of the SCOR-D. The SCOR-D is a brief standardized outcome measure linked to the DSM-IV approach toward defining remission that can be incorporated into routine clinical practice without adding undue burden to the treating clinician with some evidence of reliability and validity. This measure could make it more feasible to conduct effectiveness studies in clinical practice.

Adolescent eating disorders: treatment and response in a naturalistic study

“…Interrater reliability for clinician assessed and independent ratings of the GAF scale are excellent (Hilsenroth et al, 2000). Clinician‐rated GAF scores show convergent validity with other scales such as structured ratings of depression (e.g., Zimmerman, Posternak, Chelminski, & Friedman, 2005), interpersonal/relational functioning (Hilsenroth et al, 2000), and social/occupational functioning (Hilsenroth et al, 2000). As noted earlier, research indicates that clinician reports are particularly reliable and valid with regard to adolescent EDs (Couturier et al, 2007).…”

Relationship of residual mood and panic–agoraphobic spectrum phenomenology to quality of life and functional impairment in patients with major depression

“…Recently, Zimmerman et al (2005, 2007) compared remitted patients with different scores on the Hamilton Rating Scale for Depression (HRS-D) and found that patients with a score of 0–2 reported significantly less psychosocial impairment and better quality of life than those with a score of 3–7. This is probably reflective of the fact that the instruments commonly used to assess the severity of depression and residual symptoms are focused on typical aspects (Kennedy and Paykel, 2004; Papakostas et al , 2004; Dombrovski et al , 2007) and overlook atypical symptoms (i.e.…”

The use of brexpiprazole amongst individuals with insufficient outcomes with aripiprazole or bupropion: A case series

“…Clinical impression supported by available evidence also indicates that real world outcomes in MDD fall short of what is reported in rigorous clinical trials. The disconnect between efficacy and effectiveness outcomes has been understood to be in part a reflection of the different patient populations studied, as the majority of individuals in clinical practice would not be eligible for pivotal trials due to stringent inclusion criteria . Taken together, there is need for understanding the therapeutic effectiveness of treatments in real world practice to inform treatment decisions.…”