title: The Hamilton Depression Scale (HAM-D) and the Montgomery-Åsberg Depression Scale (MADRS). A psychometric re-analysis of the European genome-based therapeutic drugs for depression study using Rasch analysis.
abstract: The objective of this re-analysis of the European Genome-Based Therapeutic Drugs for Depression Study (GENDEP) was to psychometrically test the unidimensionality of the full Montgomery Åsberg Depression Rating Scale (MADRS10) and the Hamilton Depression Scale (HAM-D17) versus their respective subscales (MADRS5 and HAM-D6) containing the core symptoms of depression severity. Rasch analysis was applied using RUMM 2030 software to assess the overall fit for unidimensionality. Neither the MADRS10 nor the HAM-D17 was found to fit the Rasch model for unidimensionality. The HAM-D6 (containing the items of depressed mood, guilt, work and interests, psychomotor retardation, psychic anxiety, and somatic general) as well as the analogue MADRS5 were tested for unidimensionality by use of the RUMM 2030 programme, and only the HAM-D6 was accepted. When testing for invariance across rating weeks or centres, the RUMM 2030 had to be supplemented with the Friedman two-way analysis of variance by ranks. The HAM-D6 but not the MADRS5 was accepted. It was therefore concluded that the HAM-D6 is a psychometrically valid outcome scale to measure change in clinical trials of antidepressants.
authors.affiliation: Psychiatric Research Unit, Mental Health Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark. Electronic address: Per.bech@regionh.dk.
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.affiliation: Department of Educational Research (IUP), Aarhus University, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Allerup
authors.affiliation: Department of Affective Disorders, Q, Mood Disorders Research Unit, Risskov, Denmark.
authors.forename: Erik Roj
authors.initials: ER
authors.lastname: Larsen
authors.affiliation: Psychiatric Research Unit, Mental Health Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark.
authors.forename: Claudio
authors.initials: C
authors.lastname: Csillag
authors.affiliation: Psychiatric Research Unit, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Rasmus W
authors.initials: RW
authors.lastname: Licht
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology; D002986:Clinical Trials as Topic / Q000379:methods; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D004185:Disability Evaluation; D005060:Europe; D005260:Female; D015894:Genome, Human / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012984:Software
chemical_list: D000928:Antidepressive Agents
keywords: Change; Depression rating scales; Depressive disorder; Invariance over time; Rasch analysis; Trial of antidepressants; Unidimensionality