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The Use of Brexpiprazole Combined With a Stimulant in Adults With Treatment-Resistant Attention-Deficit/Hyperactivity Disorder.

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The Ham-D is not Hamilton's Depression Scale.

Leon I Rosenberg1

  • 1Rosenberg, M.D., Medical Director, Principal Investigator, Center for Emotional Fitness, Cherry Hill, New Jersey.

Psychopharmacology Bulletin
|June 20, 2022
PubMed
Summary
This summary is machine-generated.

Current versions of the Hamilton Rating Scale for Depression (HAM-D) deviate from original guidelines, impacting depression assessment accuracy. This study highlights critical scoring errors in widely used HAM-D and SIGH-D scales.

Keywords:
SIGH-Danxietyconcentrationguidelinesinsomniamajor depressive disordermeasureratingreliabilitysadness

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychometric Evaluation

Background:

  • The Hamilton Rating Scale for Depression (HAM-D) is a widely used clinical tool for assessing depressive symptom severity.
  • Current versions, including the Guy 1976 HAM-D and the Structured Interview Guide for the HAM-D (SIGH-D), are prevalent in randomized clinical trials.
  • Max Hamilton's original 1960 and 1967 guidelines established the foundational structure and intent of the scale.

Purpose of the Study:

  • To compare the response options of currently used HAM-D and SIGH-D versions against Max Hamilton's original guidelines.
  • To identify and quantify discrepancies in scale items and scoring between contemporary and historical versions.
  • To assess the potential impact of these deviations on the reliability and validity of depression measurement.

Main Methods:

  • A comparative review of seminal papers detailing the development of the HAM-D and SIGH-D was conducted.
  • Key documents included Max Hamilton's 1960 and 1967 articles, the 1976 Guy-edited ECDEU manual, and Janet Williams' 1988 and 2013 SIGH-D articles.
  • Systematic comparison of the 17 items in the Guy 1976 HAM-D and the 2013 SIGH-D against Hamilton's original guidelines.

Main Results:

  • Significant deviations were found in 13 out of 17 items when comparing current HAM-D and SIGH-D versions to Max Hamilton's 1960 and 1967 guidelines.
  • Specific examples include the omission of 'difficulty in concentration,' a core DSM criterion for Major Depressive Episode since 1980.
  • These errors indicate a departure from the original scale's intended measurement domains and response options.

Conclusions:

  • Current widely used versions of the HAM-D and SIGH-D contain significant errors compared to Max Hamilton's original guidelines.
  • These discrepancies can lead to inconsistent administration and scoring, compromising the reliability of depression symptom measurement.
  • The findings underscore the need for revisions to current HAM-D versions to align with original standards and improve assessment accuracy.