Montgomery S A, Asberg M
Br J Psychiatry. 1979 Apr;134:382-9. doi: 10.1192/bjp.134.4.382.
The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample. Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change. The inner-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.
本文描述了一种旨在对治疗效果特别敏感的抑郁评定量表的构建。对54名英国患者和52名瑞典患者在一个包含65个项目的综合精神病理学量表上的评分进行分析，以确定合并样本中原发性抑郁症最常见的17种症状。对参与四种不同抗抑郁药物研究的64名患者在这17个项目上的评分进行分析，构建了一个抑郁量表，该量表由10个在治疗中变化最大且与总体变化相关性最高的项目组成。新抑郁量表的内部评定者信度很高。该量表的得分与抑郁标准评定量表汉密尔顿评定量表（HRS）的得分显著相关，表明其作为一般严重程度评估的有效性。其区分抗抑郁治疗反应者和无反应者的能力优于HRS，表明对变化更敏感。文中还讨论了在临床试验中样本量较小的实际和伦理意义。
