Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
PLoS One. 2023 May 18;18(5):e0285665. doi: 10.1371/journal.pone.0285665. eCollection 2023.
The Hamilton Depression Rating Scale (HDRS or HAMD) is widely used scale for depression assessment. A shortened version of the HDRS, composed of 7 items, was implemented. The latter is timesaving compared to the original version, while still providing similar precision. Our objective in this study was to assess the psychometric properties of the Arabic HAMD-7 scale among non-clinical and clinical samples of Lebanese adults.
In study 1, 443 Lebanese citizens enrolled in this cross-sectional study (June-September 2021). The total sample in study 1 was divided into two subsamples to conduct the exploratory-to-confirmatory factor analysis (EFA-to-CFA). Another cross-sectional study was conducted in September 2022 on another sample of Lebanese patients (independent from the sample of study 1) and included 150 patients attending two psychology clinics. The Montgomery-Asberg Depression Rating Scale (MADRS), Lebanese Depression Scale (LDS), Hamilton Anxiety Scale (HAM-A) and Lebanese Anxiety Scale (LAS) were used to assess the validity of the HAMD-7 scale.
The results of the EFA (subsample 1; study 1) showed that the HAM-D-7 items converged into a one-factor solution (McDonald's ω = .78). The CFA (subsample 2; study 1) confirmed the one-factor solution obtained in the EFA (ω = .79). CFA indicated that fit of the one-factor model of the HAM-D-7 was acceptable: χ2/df = 27.88/14 = 1.99, RMSEA = .066 (90% CI = .028, .102), SRMR = .043, CFI = .960, TLI = .939. All indices suggested that configural, metric, and scalar invariance was supported across gender. The HAMD-7 scale score positively correlated with the MADRS (r = 0.809; p<0.001), LDS (r = 0.872; p<0.001), HAM-A (r = 0.645; p<0.001) and LAS (r = 0.651; p<0.001) scales scores. The optimal cutoff score between healthy individuals and depressive patients for the HAMD-7 was at a value = 5.50 (Se = 82.8% and Sp = 62.4%). The positive and negative predicted values for the HAMD-7 were 25.1% and 96.0%, respectively. The positive and negative likelihood ratios were 2.20 and 0.28 respectively. No significant difference was found between the non-clinical total sample (study 1) and the clinical sample (study 2) in terms of HAM-D-7 scores (5.24 ± 4.43 vs 4.54 ± 5.06; t(589) = 1.609; p = .108).
Psychometric properties of the Arabic HAMD-7 scale are satisfactory, warranting its use clinically and in research. This scale seems highly efficient for ruling out depression; however, those with positive scores need a referral to a mental health professional for deeper evaluation. HAMD-7 might be self-administered by non-clinical subjects. Future studies are recommended to additionally confirm our results.
汉密尔顿抑郁量表（HDRS 或 HAMD）是广泛用于评估抑郁症的量表。该量表的一个缩短版本由 7 个项目组成，与原始版本相比，该版本节省了时间，同时仍提供了类似的精度。我们的目的是评估阿拉伯语 HAMD-7 量表在黎巴嫩非临床和临床成人样本中的心理测量特性。
在研究 1 中，443 名黎巴嫩公民参加了这项横断面研究（2021 年 6 月至 9 月）。研究 1 中的总样本被分为两个子样本，以进行探索性-验证性因子分析（EFA-to-CFA）。2022 年 9 月，在黎巴嫩的两个心理诊所就诊的另一批 150 名患者进行了另一个横断面研究（与研究 1 的样本无关）。蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、黎巴嫩抑郁量表（LDS）、汉密尔顿焦虑量表（HAM-A）和黎巴嫩焦虑量表（LAS）用于评估 HAMD-7 量表的效度。
EFA（研究 1 子样本 1）的结果表明，HAM-D-7 项集中为一个因素解决方案（McDonald's ω =.78）。验证性因子分析（研究 1 子样本 2）证实了 EFA 中获得的单因素解决方案（ω =.79）。验证性因子分析表明，HAM-D-7 的单因素模型拟合良好：χ2/df = 27.88/14 = 1.99，RMSEA =.066（90%CI =.028，.102），SRMR =.043，CFI =.960，TLI =.939。所有指标均表明，跨性别存在配置、度量和标度不变性。HAMD-7 量表评分与 MADRS（r = 0.809；p<0.001）、LDS（r = 0.872；p<0.001）、HAM-A（r = 0.645；p<0.001）和 LAS（r = 0.651；p<0.001）量表评分呈正相关。HAMD-7 区分健康个体和抑郁患者的最佳截断值为 5.50（Se = 82.8%，Sp = 62.4%）。HAMD-7 的阳性和阴性预测值分别为 25.1%和 96.0%。阳性和阴性似然比分别为 2.20 和 0.28。非临床总样本（研究 1）和临床样本（研究 2）的 HAM-D-7 评分无显著差异（5.24 ± 4.43 vs 4.54 ± 5.06；t(589) = 1.609；p =.108）。
阿拉伯语 HAMD-7 量表的心理测量特性令人满意，值得在临床和研究中使用。该量表对于排除抑郁症非常有效；然而，那些有阳性评分的人需要转介给心理健康专业人员进行更深入的评估。非临床受试者可以自行使用 HAMD-7。建议进行更多的研究来进一步证实我们的结果。
