Videotape technique in assessing antidepressants.

In the search for superior levels of objectivity in research in clinical psychiatry videotape (VT), recordings were made of all clinical interviews with the first eleven patients entering a double-blind controlled trial of antidepressant drugs. The treating psychiatrist recorded diagnosis as listed in the ICD and described in its accompanying Glossary, and rated the Hamilton Depression Scale (HDS) at pretreatment and final interviews. A Visual Analogue Scale (VAS) for depression was independently scored by psychiatrist and patient at each interview. VT recordings were despatched for independent repetition of diagnostic assessment and ratings of mood (HDS and VAS) by two further psychiatrists, creating in effect a multiple-blind study. Agreement was satisfactory on ICD listed diagnoses and complete for the broad category of `affective disorder'. Between the three psychiatrists, there was a high correlation of HDS scores. Patients were independently agreed to form a group of moderately depressed subjects. Closely related degrees of improvement were recorded by the three psychiatrists in all patients. Correlation of scores were high for the VAS for depression as independently scored by patient, treating psychiatrist and the two VT viewers. The VAS was shown to be a simple, quick and reliable indicator of depressive mood suited to repeated use at short intervals. VT recordings are a useful tool in the search for higher levels of objectivity in clinical research. The technique described might well become as accepted in psychiatric drug trials as the blind control procedure.