Self-reported depressive symptom measures: Sensitivity to detecting change in a randomized, controlled trial of chronically depressed, nonpsychotic outpatients

A. John Rush, Madhukar H. Trivedi, Thomas J. Carmody, Hisham H. Ibrahim, John C. Markowitz, Gabor I. Keitner, Susan G. Kornstein, Bruce Arnow, Daniel N. Klein, Rachel Manber, David L. Dunner, Alan J. Gelenberg, James H. Kocsis, Charles B. Nemeroff, Jan Fawcett, Michael E. Thase, James M. Russell, Darlene N. Jody, Frances O. Borian, Martin B. Keller

Research output: Contribution to journalArticle

99 Scopus citations

Abstract

This study evaluated and compared the performance of three self-report measures: (1) 30-item Inventory of Depressive Symptomatology-Self-Report (IDS-SR30); (2) 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16); and (3) Patient Global Impression-Improvement (PGI-1) in assessing clinical outcomes in depressed patients during a 12-week, acute phase, randomized, controlled trial comparing nefazodone, cognitive-behavioral analysis system of psychotherapy (CBASP), and the combination in the treatment of chronic depression. The IDS-SR30, QIDS-SR16, PGI-1, and the 24-item Hamilton Depression Rating Scale (HDRS24) ratings were collected at baseline and at weeks 1-4, 6, 8, 10, and 12. Response was defined a priori as a ≥50% reduction in baseline total score for the IDS-SR30 or for the QIDS-SR16 or as a PGI-1 score of 1 or 2 at exit. Overall response rates (LOCF) to nefazodone were 41% (IDS-SR30), 45% (QIDS-SR16), 53% (PCI-1), and 47% (HDRS17). For CBASP, response rates were 41% (IDS-SR30), 45% (QIDS-SR16), 48% (PGI-1), and 46% (HDRS17). For the combination, response rates were 68% (IDS-SR30 and QIDS-SR 16), 73% (PGI-1), and 76% (HDRS17). Similarly, remission rates were comparable for nefazodone (IDS-SR30 = 32%, QIDS-SR 16 = 28%, PGI-1 = 22%, HDRS17 = 30%), for CBASP (IDS-SR30 = 32%, QIDS-SR16 = 30%, PGI-1 = 21%, HDRS 17 = 32%), and for the combination (IDS-SR30 = 52%, QIDS-SR16 = 50%, PGI-1 = 25%, HDRS17 = 49%). Both the IDS-SR30 and QIDS-SR16 closely mirrored and confirmed findings based on the HDRS24. These findings raise the possibility that these two self-reports could provide cost- and time-efficient substitutes for clinician ratings in treatment trials of outpatients with nonpsychotic MDD without cognitive impairment. Global patient ratings such as the PGI-1, as opposed to specific item-based ratings, provide less valid findings.

Original languageEnglish (US)
Pages (from-to)405-416
Number of pages12
JournalNeuropsychopharmacology
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2005
Externally publishedYes

Keywords

  • Chronic depression
  • Nefazodone
  • Psychotherapy
  • Symptom measures

ASJC Scopus subject areas

  • Pharmacology

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    Rush, A. J., Trivedi, M. H., Carmody, T. J., Ibrahim, H. H., Markowitz, J. C., Keitner, G. I., Kornstein, S. G., Arnow, B., Klein, D. N., Manber, R., Dunner, D. L., Gelenberg, A. J., Kocsis, J. H., Nemeroff, C. B., Fawcett, J., Thase, M. E., Russell, J. M., Jody, D. N., Borian, F. O., & Keller, M. B. (2005). Self-reported depressive symptom measures: Sensitivity to detecting change in a randomized, controlled trial of chronically depressed, nonpsychotic outpatients. Neuropsychopharmacology, 30(2), 405-416. https://doi.org/10.1038/sj.npp.1300614