[Symptoms that contribute to the perception of depressive symptom intensity. A preliminary study]

Psychiatrists use few symptoms when diagnosing depression. This study has aimed to know what symptoms are used by the psychiatrists to evaluate the severity of a depressive person compared to how they are evaluated when using a standardized instrument such as Hamilton's Rating Scale for Depression (HRSD-17).

A total of 100 depressed outpatients attended consecutively who met the ICD-10 criteria for depressive episode, dysthymia or adjustment disorders depressive types were studied. The depressed outpatients expressed their clinical situation on a Visual Analogue Scale (VAS) whose extreme values were the adjectives WELL and BAD. The psychiatrist evaluated them using a Clinical Global Impression (CGI) scale on the state of the patient's depressed mood, and Hamilton's Rating Scale for Depression (HRSD-17). The total scores obtained with those instruments and with the partial scores of the melancholic and anxious factors of the HRSD-17 were correlated (Pearson's R).

Psychiatrists give more importance to melancholic symptoms than to anxious ones to establish the severity of a depressed outpatient. Depressed outpatients give the same importance to their anxious and melancholic symptoms. In addition, the total score of the HRSD-17 is more influenced and shares a larger variance proportion with anxious symptoms than with melancholic ones. All the correlations calculated are statistically significant (p = 0.000).

The authors discuss the influence that the HRSD-17 can have on seemingly precocious results offered by some clinical trials of antidepressants drugs.