Bech.qxp 26/6/08 05:10 Page 18
Affective Spectrum Disorders Current Issues
score on depressed mood of two (mild depression) corresponded to score is then a sufficient statistic. The HAM-D
6
or MADRS
6
subscales or
a score of 16 plus or minus four. the MES have been found to be unidimensional depression scales.
Among the mania scales, the MAS is still the only scale found to be
Translation Validity of Rating Scales unidimensional. Self-rating scales are of major use in depressive states. A
Although the HAM-D is the most commonly used scale worldwide in self-reported version of the HAM-D
6
has been released, and the MD has
affective disorders, different translations of the scale are often used.
37
been developed to measure depression according to ICD-10 or DSM-IV.
The American translation
13
was never accepted by Hamilton himself,
38
but he did go on to accept the updated version used by the Danish
University Antidepressant Group (DUAG) in their trials.
39,40
This
The use of self-reported rating
updated version has been translated into French, German and
Spanish,
41
but only recently has a major attempt been made (by scales within affective disorders has
Emmanuelle Weiller and her group) to perform a translation of the
become more and more important
correct HAM-D version (including the Melancholia Scale) into several
European and Asian languages. The World Health Organization (WHO)
in depression.
procedure for the translation of rating scales is recommended.
42
Summary Standardisation of rating scales is an important aspect of their clinimetric
The rating scales for affective disorders have been classified by their use, especially in order to define remission in affective states during
psychometric or clinimetric properties as Apgar type scales (measuring a treatment. Table 5 shows standardisation, in terms of remission and
global impression of affective states), Hamilton-type scales (measuring relapse, of the various rating scales included in Table 4. The translation
factors or sub-scores of affective states) and Guttman-type scales problems when using scales in Europe have been discussed and the WHO
(measuring outcomes of treatment by the total scale score). The use of procedure for translation of rating scales has been recommended. ■
rating scales is of special interest when assessing response to treatment
(e.g. in dose–response studies) or to identify remission. In dose–response Acknowledgement
studies, unidimensional Guttman scales are meaningful because the total This study has received an educational grant from the Lundbeck Foundation.
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18 EUROPEAN PSYCHIATRIC REVIEW
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