Correlation between patient and clinician assessments of depression severity in the PREVENT study

• Type of Material: Article
• Authors: Boadie W Dunlop, Emory University; Thomas Li, Wyeth Research; Susan G. Kornstein, Virginia Commonwealth University; Edward S. Friedman, University of Pittsburgh; Anthony J. Rothschild, University of Massachusetts; Ron Pedersen, Wyeth Research; Philip Ninan, Wyeth Research; Martin Keller, Brown University
• Language: English
• Date: 2010-05-15
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 Elsevier Ireland Ltd. All rights reserved
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.psychres.2010.02.008
• Title of Journal or Parent Work: Psychiatry Research
• ISSN: 0165-1781
• Volume: 177
• Issue: 0
• Start Page: 177
• End Page: 183
• Grant/Funding Information: Dr. Dunlop is supported by a K12 grant from NIH National Center for Research Resources, K12 RR 017643 and 1KL2RR025009.; Research supported by Wyeth Research.
• Keywords: Ratings; Outcomes assessment; Inventory of depressive symptoms; Major depressive disorder; Psychiatric status rating scales; Clinical trials as a topic; Antidepressants
• Research Categories: Biology, Biostatistics; Psychology, Clinical

Abstract

Background The degree of agreement between patient- and clinician-rated scales of depressive severity varies widely. This study analyzed agreement between commonly used depression rating scales in the Prevention of Recurrent Episodes of Depression with Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial. Methods The PREVENT trial was a multiphase, randomized, double-blind study of patients with recurrent major depressive disorder. This secondary analysis evaluated acute (10 weeks) and continuation phase (6 months) data. Pearson correlation coefficients at each acute-phase (weekly) and continuation-phase (monthly) visit were calculated for patient-rated (30-item Inventory of Depressive Symptomatology-Self-Rated [IDS-SR30] and clinician-rated (17-item Hamilton Rating Scale for Depression [HAM-D17] and Clinical Global Impressions-Severity [CGI-S]) measures and for response and remission. Results Data from 1,047 patients were analyzed. The respective correlation coefficients at baseline, week 10, and month 6 were: IDS-SR30: HAM-D17: 0.46, 0.75, 0.70; and for IDS-SR30: CGI-S 0.28, 0.67, 0.65. Agreement between IDS-SR30- and HAM-D17-defined remission and response was relatively poor: week 10, 0.52 and 0.34, respectively; month 6, 0.45 and 0.32, respectively. Conclusions These findings suggest that patient-rated measures of depression severity do not correspond strongly with clinician ratings, and are particularly poor prior to the initiation of treatment.