Measuring the severity of depression and remission in primary care: Validation of the HAMD-7 scale

Roger S. McIntyre, Jakub Z. Konarski, Deborah A. Mancini, Kari A. Fulton, Sagar V. Parikh, Sophie Grigoriadis, Larry A. Grupp, David Bakish, Marie Josee Filteau, Chris Gorman, Charles Nemeroff, Sidney H. Kennedy

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Background: Symptomatic remission is the optimal outcome in depression. A brief, validated tool for symptom measurement that can indicate when remission has occurred in mental health and primary care settings is unavailable. We evaluated a 7-item abbreviated version (HAMD-7) of the 17-item Hamilton Depression Rating Scale (HAMD-17) in a randomized controlled clinical trial of patients with major depressive disorder being cared for in primary care settings. Methods: We enrolled 454 patients across 47 primary care settings who met DSM-IV-TR criteria for a major depressive disorder. Of these, 410 patients requiring antidepressant medication were randomized to have their symptoms rated with either HAMD-7 (n = 205) or HAMD-17 (n = 205) as the primary measurement tool. The primary outcome was the proportion of patients who achieved a-priori defined responses to 8 weeks of therapy using each instrument. Results: Of the 205 participants per group, 67% of those evaluated with HAMD-7 were classified as having responded to therapy (defined as a ≥ 50% reduction from the pretreatment score), compared with 74% of those evaluated with HAMD-17 (p = 0.43). The difference between the groups' changes in scores from baseline (pretreatment) to endpoint was significant (p < 0.001), without a main effect of group (p = 0.84) or group-by-time (p = 0.83) interaction. The HAMD-7 test was brief to administer (e.g., 3-4 min for 85% of the primary care physicians evaluated), which facilitated the efficient and structured evaluation of salient depressive symptoms. Interpretation: The abbreviated HAMD-7 depression scale is equivalent to the HAMD-17 in assessing remission in patients with a major depressive disorder undergoing drug therapy. 1327-1331

Original languageEnglish
Pages (from-to)1327-1331
Number of pages5
JournalCMAJ
Volume173
Issue number11
DOIs
StatePublished - Nov 22 2005
Externally publishedYes

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Primary Health Care
Depression
Major Depressive Disorder
Primary Care Physicians
Diagnostic and Statistical Manual of Mental Disorders
Antidepressive Agents
Mental Health
Randomized Controlled Trials
Delivery of Health Care
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

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McIntyre, R. S., Konarski, J. Z., Mancini, D. A., Fulton, K. A., Parikh, S. V., Grigoriadis, S., ... Kennedy, S. H. (2005). Measuring the severity of depression and remission in primary care: Validation of the HAMD-7 scale. CMAJ, 173(11), 1327-1331. https://doi.org/10.1503/cmaj.050786

Measuring the severity of depression and remission in primary care : Validation of the HAMD-7 scale. / McIntyre, Roger S.; Konarski, Jakub Z.; Mancini, Deborah A.; Fulton, Kari A.; Parikh, Sagar V.; Grigoriadis, Sophie; Grupp, Larry A.; Bakish, David; Filteau, Marie Josee; Gorman, Chris; Nemeroff, Charles; Kennedy, Sidney H.

In: CMAJ, Vol. 173, No. 11, 22.11.2005, p. 1327-1331.

Research output: Contribution to journalArticle

McIntyre, RS, Konarski, JZ, Mancini, DA, Fulton, KA, Parikh, SV, Grigoriadis, S, Grupp, LA, Bakish, D, Filteau, MJ, Gorman, C, Nemeroff, C & Kennedy, SH 2005, 'Measuring the severity of depression and remission in primary care: Validation of the HAMD-7 scale', CMAJ, vol. 173, no. 11, pp. 1327-1331. https://doi.org/10.1503/cmaj.050786
McIntyre RS, Konarski JZ, Mancini DA, Fulton KA, Parikh SV, Grigoriadis S et al. Measuring the severity of depression and remission in primary care: Validation of the HAMD-7 scale. CMAJ. 2005 Nov 22;173(11):1327-1331. https://doi.org/10.1503/cmaj.050786
McIntyre, Roger S. ; Konarski, Jakub Z. ; Mancini, Deborah A. ; Fulton, Kari A. ; Parikh, Sagar V. ; Grigoriadis, Sophie ; Grupp, Larry A. ; Bakish, David ; Filteau, Marie Josee ; Gorman, Chris ; Nemeroff, Charles ; Kennedy, Sidney H. / Measuring the severity of depression and remission in primary care : Validation of the HAMD-7 scale. In: CMAJ. 2005 ; Vol. 173, No. 11. pp. 1327-1331.
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AU - Fulton, Kari A.

AU - Parikh, Sagar V.

AU - Grigoriadis, Sophie

AU - Grupp, Larry A.

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AU - Filteau, Marie Josee

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AU - Nemeroff, Charles

AU - Kennedy, Sidney H.

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N2 - Background: Symptomatic remission is the optimal outcome in depression. A brief, validated tool for symptom measurement that can indicate when remission has occurred in mental health and primary care settings is unavailable. We evaluated a 7-item abbreviated version (HAMD-7) of the 17-item Hamilton Depression Rating Scale (HAMD-17) in a randomized controlled clinical trial of patients with major depressive disorder being cared for in primary care settings. Methods: We enrolled 454 patients across 47 primary care settings who met DSM-IV-TR criteria for a major depressive disorder. Of these, 410 patients requiring antidepressant medication were randomized to have their symptoms rated with either HAMD-7 (n = 205) or HAMD-17 (n = 205) as the primary measurement tool. The primary outcome was the proportion of patients who achieved a-priori defined responses to 8 weeks of therapy using each instrument. Results: Of the 205 participants per group, 67% of those evaluated with HAMD-7 were classified as having responded to therapy (defined as a ≥ 50% reduction from the pretreatment score), compared with 74% of those evaluated with HAMD-17 (p = 0.43). The difference between the groups' changes in scores from baseline (pretreatment) to endpoint was significant (p < 0.001), without a main effect of group (p = 0.84) or group-by-time (p = 0.83) interaction. The HAMD-7 test was brief to administer (e.g., 3-4 min for 85% of the primary care physicians evaluated), which facilitated the efficient and structured evaluation of salient depressive symptoms. Interpretation: The abbreviated HAMD-7 depression scale is equivalent to the HAMD-17 in assessing remission in patients with a major depressive disorder undergoing drug therapy. 1327-1331

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