The Symptom Frequency Characteristics of the Hamilton Depression Rating Scale and Possible Symptom Clusters of Depressive Disorders in Korea: The CRESCEND Study

Abstract

ObjectiveThis study analyzed the symptom frequencies of 17-item Hamilton Depression Rating Scale (HDRS-17) to understand the characteristics of each item and to propose the possible symptoms clusters.MethodsFrom psychiatric clinics of 18 Hospitals in Korea, 1,183 patients, diagnosed with major depressive disorder (psychotic or non-psychotic), dysthymia or depressive disorder not otherwise specified. according to DSM-IV criteria, participated in this study from January 2006 to August 2008. The frequencies of each item of HDRS-17 were analyzed according to sex and severity. In addition, we compared this study with a previous study performed in England by Hamilton and with two studies performed in Korea by Kim et al.ResultsThe frequencies of HDRS-17 items varied widely in this study, ranging from 95.8% in work and activities to 37.4% in loss of weight. But, depressed mood, psychic anxiety and work and activities items exhibited constant and higher frequency or rank regardless of study, the severity of depression or sex. Insomnia early, somatic gastrointestinal, genital symptoms and insight showed relatively constant but lower frequency or rank in disregard of studies or the clinical variables. Other symptoms had variable frequencies or ranks according to the variable clinical situations (culture, time, sex, severity of depression).ConclusionWe propose three clusters of symptoms in depressive disorders: core symptoms cluster, an associated symptoms, and a situation-specific symptoms. We can use these possible symptom clusters of depression in simplifying diagnosis of depression, increasing diagnostic specificity in special situation and indexing disease severity.

Cross-Cultural Psychometric Properties of the Hamilton Depression Rating Scale

“…The resulting list of studies is presented in Table 2, and an overview of methods and results of each study is presented in Table 3. 6,7,10,[12][13][14][15][16][17][18][19][20] Four studies included Western samples for comparison. The study by Furukawa and colleagues 15 qualified for this review due to its Japanese sample but also contains a US and a European sample.…”

“…Fifty depressive patients, both inpatients and outpatients. Jang et al 10 Korea (n ¼ 1183) Both in-and outpatients diagnosed with major depressive disorder (psychotic or nonpsychotic), dysthymia, or depressive disorder not otherwise specified according to DSM-IV criteria. Exclusion criteria: diagnosis of schizophrenia, organic mental disorder, seizure disorder, eating disorder, brief psychotic disorder, or schizoaffective disorder, or presence of clinically significant nephrological, haematological, cardiovascular, respiratory, cerebrovascular, or endocrinological disease.…”

“…The frequencies of each item pair were ordered in a matrix, allowing for a visual inspection of the most frequently co-occurring pairs or clusters of items. One study 10 did not report a factor structure but provided a correlation matrix, which we were able to subject to principal component analysis. For this, we used varimax rotation and Kaiser's normalisation, while the number of extracted components was determined with Cattell's scree test.…”

Latent structure of the symptomatology of hospitalized patients with bipolar mania

“…This was an unexpected result because suicidal symptoms tend to appear among depressive symptoms [46,34,18,33]. To understand these results, two hypotheses could be raised: suicidal tendencies are an isolated dimension in psychiatric diseases and need to be separated from other symptomatology because they could appear because of several factors (e.g., aggressive behavior [39], impulsivity [55], rejection [1], pain [8], and depression [48]); suicide indeed loads in depression and the present study's results are misleading due to the adopted methods.…”

“…This means that the SADS-C appears to be a good measure for detecting insomnia symptoms. Finding a manic patient with insomnia problems caused by excessive energy and agitation is not unusual, and several studies show evidence supporting it [46,30,34,48,31]. However, why did insomnia not load in the manic factor?…”