Assessment of mood state in patients undergoing electroconvulsive therapy: the utility of visual analog mood scales developed for cognitively impaired patients.

Reliable, valid, and brief measures of mood state are essential to the evaluation of electroconvulsive therapy (ECT) efficacy. However, existing measures of mood state may be inappropriate for patients with transient cognitive impairment. Stern and colleagues have recently developed a set of Visual Analog Mood Scales (VAMS) for use in neurologically impaired patients. These brief scales (including measures of sad, confused, afraid, happy, tired, angry, and energetic states) are easily administered and have documented reliability and validity in neurologically impaired patients and in healthy adult and geriatric samples. In the present study, we assessed the validity and sensitivity of the VAMS to detect ECT-related mood change. Twenty-five inpatients who were diagnosed with major depressive episode and referred for ECT were administered the VAMS and the Hamilton Depression Rating Scale (HDRS) both pre- and post-ECT. Results indicate that the VAMS are as sensitive to the therapeutic effects of ECT as is the more lengthy and verbally demanding HDRS. In addition, the VAMS were highly correlated with the clinician's Clinical Global Improvement rating and the patient's self-report using a modified Center for Epidemiological Studies-Depression scale. The VAMS are brief, reliable scales that are sensitive to the treatment effects of ECT and that are appropriate for patients with transient cognitive impairment.