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The Inventory of Depressive Symptomatology (IDS-C28) is more sensitive to changes in depressive symptomatology than the Hamilton Depression Rating Scale (HAMD17) in patients with mild major, minor or subsyndromal depression

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Abstract

Depression rating scales play a decisive role in the assessment of the severity of depression and the evaluation of the efficacy of antidepressant treatments. The Hamilton Depression Rating Scale (HAMD) is regarded as the ‘gold standard’; nevertheless, studies suggest that the Inventory of Depressive Symptomatology (IDS) is more sensitive to detect symptom changes. The aim of the present study was to investigate whether the IDS is more sensitive in detecting changes in depression symptoms in patients with mild major, minor or subsyndromal depression (MIND). Biweekly IDS-C28 and HAMD17 data from 340 patients of a 10-week randomized, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural therapy in patients with MIND were analysed. We investigated sensitivity to change for both scales (1) from assessment-to-assessment, (2) in relation to depression severity level, and (3) in relation to DSM-IV depression criterion symptoms. The IDS-C28 was more sensitive in detecting changes in depression symptomatology over the treatment course as well as for different severity levels, especially in patients with a low depression severity. It assesses the DSM-IV criteria more thoroughly, is better able to track the change of cognitive symptoms and to identify residual symptoms. Both scales are well able to assess depressive symptomatology. However, the IDS-C28 surpasses the HAMD17 in detecting small changes especially in the core symptoms of depression. This is important for an optimal treatment by capturing early improvements, enabling prompt reactions and detecting residual symptoms.

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Acknowledgments

We are grateful to all patients who participated in the study, the general practitioners who screened the patients within the network of medical practices, Nuremberg North, especially Veit Wambach, MD, Vanadis Kamm-Kohl, MD, and the practice staff. We are indebted to Patrick Bussfeld, MD, Ute Hägele, MD, Winfried Scheunemann†, Michael Schütze, MD, the physicians who investigated the patients at the specialized study center, Michaela König, MSc, Stephanie Lösch, MSc, Michael Stürmer, MSc who monitored the progress of the study and Professor Hans-Jürgen Möller, MD for his contributions to design and methods of the RCT reported here (trial registration: clinicaltrials.gov; URL: http://www.clinicaltrials.gov; registration number: NCT00226642). We are also thankful to Suzanne Snead, PhD, for the fruitful discussion of the manuscript. Funding for the study was provided by the German Ministry for Education and Research (BMBF; grant: 01 GI 9922/0222/0452) within the promotional emphasis ‘German Research Network on Depression and Suicidality’. The BMBF had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

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Correspondence to Isabella Helmreich.

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U. Hegerl and A. Tadić contributed equally to this work.

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Helmreich, I., Wagner, S., Mergl, R. et al. The Inventory of Depressive Symptomatology (IDS-C28) is more sensitive to changes in depressive symptomatology than the Hamilton Depression Rating Scale (HAMD17) in patients with mild major, minor or subsyndromal depression. Eur Arch Psychiatry Clin Neurosci 261, 357–367 (2011). https://doi.org/10.1007/s00406-010-0175-1

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