Snaith R P
Academic Unit of Psychiatry, St James's University Hospital, Leeds.
Br J Psychiatry. 1996 May;168(5):594-7. doi: 10.1192/bjp.168.5.594.
The Hamilton Depression Rating Scale retains its primacy in research. There have been recent important critiques. It is clear that instructions provided by its author are widely overlooked.
A survey of the present use of the HDRS was conducted by inspection of five major journals publishing studies in the field of psychiatry. Note was especially made of whether a recognised version of the Scale was quoted; also of whether authors had selected specific scores on one or other of the versions to indicate a criterion for inclusion of a subject in a study, and likewise whether a specific score had been selected as an indication of recovery following some procedure or treatment.
One hundred and fourteen articles were reviewed in which 71 had used a depression scale. This was the HDRS in 66% of the studies. There was considerable evidence that the instruction that the HDRS was only to be used in situations where the patient had received a diagnosis of a primary depressive illness had been ignored. There was considerable degree of arbitrary selection of Scale scores.
The survey causes concern about the methodology of much research in the field as of assessment of severity of psychiatric disorder. The rationale of assessment by the rating scale method is considered and suggestion made for improvement in research practice.
汉密尔顿抑郁量表在研究中仍占据主导地位。近期出现了一些重要的批评意见。显然，该量表作者提供的使用说明被广泛忽视。
通过查阅五本发表精神病学领域研究的主要期刊，对汉密尔顿抑郁量表目前的使用情况进行了调查。特别留意是否引用了该量表的公认版本；作者是否在某个版本上选择了特定分数来表明将受试者纳入研究的标准，同样地，是否选择了特定分数来表明经过某种程序或治疗后的康复情况。
共查阅了114篇文章，其中71篇使用了抑郁量表。在66%的研究中使用的是汉密尔顿抑郁量表。有大量证据表明，汉密尔顿抑郁量表仅适用于患者已被诊断为原发性抑郁症的情况这一使用说明被忽视了。量表分数的选择存在相当大的随意性。
该调查引发了对该领域许多关于精神障碍严重程度评估研究方法的担忧。对采用评定量表法进行评估的基本原理进行了思考，并对研究实践的改进提出了建议。
