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The Symptom Frequency Characteristics of the Hamilton Depression Rating Scale and Possible Symptom Clusters of
Sae-Heon Jang1, Young-Nam Park, Young-Myo Jae
1Department of Neuropsychiatry, Bongseng Memorial Hospital, Busan, Korea.
Insights
This study analyzed depression symptoms using the 17-item Hamilton Depression Rating Scale (HDRS-17). It identified three symptom clusters: core, associated, and situation-specific, aiding depression diagnosis and severity assessment.
Area of Science:
- Psychiatry
- Clinical Psychology
- Mental Health Research
Background:
- The 17-item Hamilton Depression Rating Scale (HDRS-17) is widely used to assess depression severity.
- Understanding symptom frequencies and their clustering is crucial for accurate diagnosis and treatment.
- Previous studies have shown variations in symptom presentation across different populations and contexts.
Purpose of the Study:
- To analyze the symptom frequencies of the HDRS-17 in a large Korean cohort.
- To identify distinct symptom clusters within depressive disorders.
- To propose a framework for simplifying depression diagnosis and improving specificity.
Main Methods:
- Analysis of HDRS-17 item frequencies in 1,183 patients diagnosed with depressive disorders according to DSM-IV criteria.
- Data collected from psychiatric clinics across 18 hospitals in Korea between January 2006 and August 2008.
- Comparison of findings with previous studies from England and Korea, considering sex and depression severity.
Main Results:
- HDRS-17 item frequencies varied significantly, from 95.8% (work and activities) to 37.4% (loss of weight).
- Depressed mood, psychic anxiety, and work/activities showed consistently high frequencies across all variables.
- Insomnia (early), somatic (gastrointestinal), genital symptoms, and insight had consistently low frequencies.
Conclusions:
- Three distinct symptom clusters were proposed: core, associated, and situation-specific.
- These clusters can aid in simplifying depression diagnosis.
- The proposed clusters may enhance diagnostic specificity in particular situations and improve disease severity indexing.
Objective:
This study analyzed the symptom frequencies of 17-item Hamilton Depression Rating Scale (HDRS-17) to understand the characteristics of each item and to propose the possible symptoms clusters.
Methods:
From psychiatric clinics of 18 Hospitals in Korea, 1,183 patients, diagnosed with major depressive disorder (psychotic or non-psychotic), dysthymia or depressive disorder not otherwise specified. according to DSM-IV criteria, participated in this study from January 2006 to August 2008. The frequencies of each item of HDRS-17 were analyzed according to sex and severity. In addition, we compared this study with a previous study performed in England by Hamilton and with two studies performed in Korea by Kim et al.
Results:
The frequencies of HDRS-17 items varied widely in this study, ranging from 95.8% in work and activities to 37.4% in loss of weight. But, depressed mood, psychic anxiety and work and activities items exhibited constant and higher frequency or rank regardless of study, the severity of depression or sex. Insomnia early, somatic gastrointestinal, genital symptoms and insight showed relatively constant but lower frequency or rank in disregard of studies or the clinical variables. Other symptoms had variable frequencies or ranks according to the variable clinical situations (culture, time, sex, severity of depression).
Conclusion:
WE PROPOSE THREE CLUSTERS OF SYMPTOMS IN DEPRESSIVE DISORDERS: core symptoms cluster, an associated symptoms, and a situation-specific symptoms. We can use these possible symptom clusters of depression in simplifying diagnosis of depression, increasing diagnostic specificity in special situation and indexing disease severity.
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