Rating scales for mood disorders: applicability, consistency and construct validity

Rating scales for mood disorders have been reviewed with special reference to their consistency, applicability, and validity. Diagnostic scales with a biometric reference to antidepressants have been developed on the basis of the Newcastle Scales. This Diagnostic Melancholia Scale (DMS) includes two dimensions, one measuring endogenous depression, and one measuring reactive depression. These dimensions were found not to be mutually exclusive as 30% of the depressed patients scored high on both dimensions. Scales measuring outcomes of treatment were subdivided into (a) scales measuring disability of clinical depression (melancholia), anxiety, and mania, (b) scales measuring distress as a construct of side-effects during treatment, and (c) scales measuring discomfort or quality of life. Disability, distress and discomfort should be separately validated as they reflect different aspects of outcome of treatment. Self-rating scales have their main applicability in the measurement of discomfort.