Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Germany.
Eur Arch Psychiatry Clin Neurosci. 2011 Aug;261(5):357-67. doi: 10.1007/s00406-010-0175-1. Epub 2010 Dec 4.
Depression rating scales play a decisive role in the assessment of the severity of depression and the evaluation of the efficacy of antidepressant treatments. The Hamilton Depression Rating Scale (HAMD) is regarded as the 'gold standard'; nevertheless, studies suggest that the Inventory of Depressive Symptomatology (IDS) is more sensitive to detect symptom changes. The aim of the present study was to investigate whether the IDS is more sensitive in detecting changes in depression symptoms in patients with mild major, minor or subsyndromal depression (MIND). Biweekly IDS-C(28) and HAMD(17) data from 340 patients of a 10-week randomized, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural therapy in patients with MIND were analysed. We investigated sensitivity to change for both scales (1) from assessment-to-assessment, (2) in relation to depression severity level, and (3) in relation to DSM-IV depression criterion symptoms. The IDS-C(28) was more sensitive in detecting changes in depression symptomatology over the treatment course as well as for different severity levels, especially in patients with a low depression severity. It assesses the DSM-IV criteria more thoroughly, is better able to track the change of cognitive symptoms and to identify residual symptoms. Both scales are well able to assess depressive symptomatology. However, the IDS-C(28) surpasses the HAMD(17) in detecting small changes especially in the core symptoms of depression. This is important for an optimal treatment by capturing early improvements, enabling prompt reactions and detecting residual symptoms.
抑郁评定量表在评估抑郁严重程度和评估抗抑郁治疗效果方面起着决定性作用。汉密尔顿抑郁评定量表（HAMD）被认为是“金标准”；然而，研究表明，抑郁症状量表（IDS）更能敏感地检测到症状变化。本研究旨在探讨 IDS 是否更能敏感地检测到轻度、中度或亚综合征性抑郁症（MIND）患者抑郁症状的变化。对 340 例接受为期 10 周的随机、安慰剂对照试验的患者进行了每隔两周的 IDS-C（28）和 HAMD（17）数据分析，该试验比较了舍曲林和认知行为疗法对 MIND 患者的疗效。我们从评估到评估（1）、与抑郁严重程度水平的关系（2）以及与 DSM-IV 抑郁标准症状的关系（3），调查了两种量表的变化敏感性。在治疗过程中以及在不同严重程度水平上，IDS-C（28）在检测抑郁症状变化方面更为敏感，尤其是在抑郁严重程度较低的患者中。它更全面地评估了 DSM-IV 标准，更能跟踪认知症状的变化，并能识别残留症状。两种量表都能很好地评估抑郁症状。然而，IDS-C（28）在检测特别是抑郁症核心症状的微小变化方面优于 HAMD（17）。这对于通过捕捉早期改善、能够快速反应和检测残留症状来实现最佳治疗非常重要。
