McIntyre R S, Konarski J Z, Kennedy S H, Dickens S E, Bagby R M
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Int J Clin Pract. 2007 Aug;61(8):1278-82. doi: 10.1111/j.1742-1241.2007.01448.x. Epub 2007 Jun 22.
The majority of individuals with major depressive disorder are diagnosed and treated in the primary-care setting. A quantifiable critical objective in the management of depression is to achieve and sustain full symptomatic remission. The HAMD-7 is a depression metric validated in both tertiary and primary-care settings.
Herein, we further characterise the psychometric properties of the HAMD-7 in depressed patients treated in primary-care settings. Several cut-scores were evaluated for maximum agreement; diagnostic efficacy statistics with the original HAMD-7 items were also evaluated. We compared performance of the HAMD-7 in primary care to a previously characterised tertiary sample.
The depressive symptoms most frequently endorsed (>or=70%) and most sensitive to change during antidepressant treatment in depressed primary-care patients were depressed mood, guilt, work and activities, psychic and somatic anxiety and fatigue.
This is a post hoc analysis of a primary-care database; assumptions regarding the definition of symptomatic remission in depression affect interpretation.
Measurement-based care with the HAMD-7 quantifies the severity of commonly reported depressive items and their responsivity to treatment. The HAMD-7, inclusive of the suicide item, is capable of tracking symptom progress, with a validated remission cut-score.
大多数重度抑郁症患者在初级保健机构接受诊断和治疗。抑郁症管理中的一个可量化的关键目标是实现并维持症状完全缓解。汉密尔顿抑郁量表-7（HAMD-7）是一种在三级医疗机构和初级保健机构均得到验证的抑郁评估指标。
在此，我们进一步描述HAMD-7在初级保健机构治疗的抑郁症患者中的心理测量特性。评估了几个临界值以达到最大一致性；还评估了与原始HAMD-7项目相关的诊断效能统计数据。我们将HAMD-7在初级保健中的表现与之前描述的三级样本进行了比较。
在初级保健抑郁症患者中，最常被认可（≥70%）且在抗抑郁治疗期间对变化最敏感的抑郁症状是情绪低落、内疚、工作和活动、精神和躯体焦虑以及疲劳。
这是对一个初级保健数据库的事后分析；关于抑郁症症状缓解定义的假设影响解释。
基于HAMD-7的测量护理可量化常见抑郁项目的严重程度及其对治疗的反应性。包含自杀项目的HAMD-7能够追踪症状进展，并具有经过验证的缓解临界值。
