Tabuse Hideaki, Kalali Amir, Azuma Hideki, Ozaki Norio, Iwata Nakao, Naitoh Hiroshi, Higuchi Teruhiko, Kanba Shigenobu, Shioe Kunihiko, Akechi Tatsuo, Furukawa Toshi A
Holy Cross Hospital, Kujiri 2431-160, Izumi-cho, Toki, 509-5142 Japan.
Psychiatry Res. 2007 Sep 30;153(1):61-7. doi: 10.1016/j.psychres.2006.07.004. Epub 2007 Apr 18.
The Hamilton Rating Scale for Depression (HAMD) is the de facto international gold standard for the assessment of depression. There are some criticisms, however, especially with regard to its inter-rater reliability, due to the lack of standardized questions or explicit scoring procedures. The GRID-HAMD was developed to provide standardized explicit scoring conventions and a structured interview guide for administration and scoring of the HAMD. We developed the Japanese version of the GRID-HAMD and examined its inter-rater reliability among experienced and inexperienced clinicians (n=70), how rater characteristics may affect it, and how training can improve it in the course of a model training program using videotaped interviews. The results showed that the inter-rater reliability of the GRID-HAMD total score was excellent to almost perfect and those of most individual items were also satisfactory to excellent, both with experienced and inexperienced raters, and both before and after the training. With its standardized definitions, questions and detailed scoring conventions, the GRID-HAMD appears to be the best achievable set of interview guides for the HAMD and can provide a solid tool for highly reliable assessment of depression severity.
汉密尔顿抑郁量表(HAMD)是评估抑郁症的事实上的国际金标准。然而,它也受到一些批评,特别是在评定者间信度方面,因为缺乏标准化问题或明确的评分程序。GRID - HAMD的开发是为了提供标准化的明确评分规范以及用于HAMD施测和评分的结构化访谈指南。我们开发了GRID - HAMD的日语版本,并在经验丰富和缺乏经验的临床医生(n = 70)中检验了其评定者间信度,评定者特征如何影响它,以及在使用录像访谈的模型培训项目过程中培训如何改善它。结果表明,GRID - HAMD总分的评定者间信度极佳至近乎完美,大多数单个项目的信度在经验丰富和缺乏经验的评定者中,以及培训前后也都令人满意至极佳。凭借其标准化的定义、问题和详细的评分规范,GRID - HAMD似乎是HAMD可实现的最佳访谈指南集,并且可以为高度可靠地评估抑郁严重程度提供坚实的工具。