title: Preliminary data of a HAMD-17 validated symptom scale derived from the ICD-10 to diagnose depression in outpatients.
abstract: BACKGROUND
  In outpatient settings diagnostic classification of depressive symptoms is mostly descriptive based on ICD-10. Depending on clinical experience and consultation time, diagnosis can be verified by validated scales. However, physicians working in primary care are familiar with ICD-10 criteria. Therefore, the aim of the present study was to examine the feasibility of the validation of an ICD-10-derived symptom scale for depression.
  
  
  METHODS
  For this preliminary trial we generated a symptom scale derived 1:1 from the diagnostic criteria for depression given in the ICD-10 with 10 items. The Hamilton Rating Scale for Depression (HAMD-17) was used as reference in a population of 226 outpatients suffering from depressive symptoms. Correlation between scales as well as sensitivity and specificity of the ICD-10 scale were calculated.
  
  
  RESULTS
  The generated ICD-10 symptom scale for depression could be analyzed in 219 patients and showed a significant and strong correlation with the HAMD-17 (p < 0.0001; ρ = 0.75). The best tradeoffs between specificity and sensitivity of the ICD-10 score were found at 10 points for the lower and 14 points for the upper cut-off. Overall sensitivity and specificity was 76.7 and 88.6%. Almost two thirds (i.e. 65.3%) of the patients were correctly classified by the ICD-10 scale.
  
  
  CONCLUSIONS
  The ICD-10 symptom scale examined in the current population was found to have fair correlation with the HAMD-17 as well as, in face of the limited variance of the patients' condition, acceptable sensitivity and specificity. Therefore, this preliminary study showed that the ICD-10-derived symptom scale seems appropriate to be investigated in a thorough validation trial.
authors.affiliation: Institute of Complementary Medicine, University Hospital Zurich, Switzerland. joerg.melzer@usz.ch
authors.forename: Jörg
authors.initials: J
authors.lastname: Melzer
authors.forename: Matthias
authors.initials: M
authors.lastname: Rostock
authors.forename: Reto
authors.initials: R
authors.lastname: Brignoli
authors.forename: Martin E
authors.initials: ME
authors.lastname: Keck
authors.forename: Reinhard
authors.initials: R
authors.lastname: Saller
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003865:Major Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D015203:Reproducibility of Results; D013223:Statistics as Topic; D055815:Young Adult