title: Speaking a more consistent language when discussing severe depression: a calibration study of 3 self-report measures of depressive symptoms.
abstract: OBJECTIVE
  We recently found marked disparities between 3 self-report scales that assess the DSM-IV criteria for major depressive disorder in the percentage of depressed outpatients considered to have severe depression. The goal of the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project was to calibrate the measures against a clinician-rated criterion standard and to establish a cutoff point on each scale that identifies a similar prevalence of severe depression and increases the level of agreement between the scales in identifying severe depression.
  
  
  METHODS
  353 depressed outpatients (DSM-IV) completed the Clinically Useful Depression Outcome Scale, Quick Inventory of Depressive Symptomatology, and Patient Health Questionnaire from June 2010 to January 2013. The patients were also rated on the 17-item Hamilton Depression Rating Scale (HDRS). The goal of the analyses was to identify the cutoff point on each of the self-report scales that would identify a prevalence of severe depression similar to that identified by the HDRS (defined as a score of 25 and above).
  
  
  RESULTS
  On the basis of the scale developers' recommended cutoffs, the prevalence of severe depression varied greatly (range, 15.3%-67.4%), and the level of agreement between the pairs of scales was low. After calibration, the self-report scales identified a similar percentage of patients as severely depressed (range, 22.2%-26.5%), and the level of agreement between the scales in identifying severe depression increased.
  
  
  CONCLUSIONS
  If clinicians are to follow treatment guidelines' recommendations to base initial treatment selection, in part, on depression severity, then it is important to have a consistent method of determining depression severity. The present calibration study of 3 self-report depression questionnaires identified cutoff scores that resulted in similar prevalence rates of severe depression and increased the level of agreement between the scales.
authors.affiliation: 146 West River St, Providence, RI 02904 mzimmerman@lifespan.org.
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Martinez
authors.forename: Michael
authors.initials: M
authors.lastname: Friedman
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Boerescu
authors.forename: Naureen
authors.initials: N
authors.lastname: Attiullah
authors.forename: Cristina
authors.initials: C
authors.lastname: Toba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002138:Calibration; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000592:standards; D057566:Self Report / Q000592:standards*; D012720:Severity of Illness Index; D055815:Young Adult