Evaluation of mood and the effect of angiotensin-converting enzyme inhibitors.

Tests used to evaluate the impact of drug therapies on mood and well-being need to be more sensitive than standard psychiatric tests, and specific procedures for the construction and validation of such instruments have been developed. Suitable questions are selected from an initial pool of possible test items and a questionnaire is formed. This undergoes a pretest procedure to eliminate any unclear or offensive questions and is then evaluated in a suitable group of patients for validity, responsiveness (i.e. sensitivity) and reproducibility. Using tests developed in this way, it has been shown that the transfer of hypertensive patients from standard triple therapy to placebo is accompanied by an increase in perceived well-being. Subsequent treatment with enalapril produced a further small increase in well-being. These and other results indicate that although angiotensin-converting enzyme (ACE) inhibitors may not have positive mood elevating properties, they are beneficial in terms of quality of life during treatment.