Department of Psychiatry, Maastricht University Medical Centre, AZ Maastricht, The Netherlands.
J Psychosom Res. 2010 Jun;68(6):561-5. doi: 10.1016/j.jpsychores.2009.10.006. Epub 2009 Dec 5.
To assess the influence of somatic symptoms of the Hamilton Depression Rating Scale (HAMD) and Montgomery-Asberg Depression Rating Scale (MADRS) on the clinimetric performance of these scales in patients with Parkinson's disease (PD).
A total of 224 patients underwent a protocolized mental status examination, consisting of the Structured Clinical Interview for DSM-IV depressive disorder (SCID-D), as well as the HAMD and MADRS. Sensitivity, specificity, positive, and negative predictive values for a range of cut-off scores were calculated for both rating scales and for modified versions of these scales in which all somatic items were eliminated. In addition, receiver operating characteristic (ROC) curves were obtained for both the modified and unmodified scales.
Elimination of the somatic items of depression from the HAMD and MADRS resulted in a reduced specificity of both the HAMD and the MADRS, and an increased sensitivity of the MADRS.
The authors recommend the full version of the HAMD and MADRS if used for diagnostic purposes; for screening purposes, the abbreviated version without somatic items can be used. Additional advantages of using full rating scales, with somatic items included, are that these provide more information on the severity of depression and allow for easier comparison across studies.
评估汉密尔顿抑郁评定量表（HAMD）和蒙哥马利-阿斯伯格抑郁评定量表（MADRS）的躯体症状对这些量表在帕金森病（PD）患者中的临床计量学性能的影响。
共有 224 名患者接受了一项方案化的精神状态检查，包括 DSM-IV 抑郁障碍定式临床访谈（SCID-D），以及 HAMD 和 MADRS。计算了这两种量表以及这些量表的修正版（所有躯体项目均被删除）的各种截断值的灵敏度、特异性、阳性和阴性预测值。此外，还获得了修正版和未修正版量表的受试者工作特征（ROC）曲线。
从 HAMD 和 MADRS 中删除抑郁的躯体项目导致 HAMD 和 MADRS 的特异性降低，而 MADRS 的灵敏度增加。
如果用于诊断目的，作者建议使用 HAMD 和 MADRS 的完整版本；如果用于筛查目的，可以使用不包含躯体项目的缩写版本。使用包含躯体项目的完整量表的额外优点是，这些量表提供了更多关于抑郁严重程度的信息，并允许更容易地在研究之间进行比较。
