Abstract
BackgroundSeveral studies have recognized that depression is a multidimensional construct, although the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression. The objective of this study is to integrate information from instruments that measure depression from different perspectives–a self-report symptomatic scale, a clinician-rated scale, and a clinician-rated scale of depressive signs–in order to investigate the multiple dimensions underlying the depressive construct.MethodsA sample of 399 patients from a mood disorders outpatient unit was investigated with the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS), and the Core Assessment of Psychomotor Change (CORE). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate underlying dimensions of depression, including item level analysis with factor loadings and item thresholds.ResultsA solution of six depression dimensions has shown good-fit to the data, with no cross-loading items, and good interpretability. Item-level analysis revealed that the multidimensional depressive construct might be organized into a continuum of severity in the following ascending order: sexual, cognitive, insomnia, appetite, non-interactiveness/motor retardation, and agitation.ConclusionAn integration of both signs and symptoms, as well as the perspectives of clinicians and patients, might be a good clinical and research alternative for the investigation of multidimensional issues within the depressive syndrome. As predicted by theoretical models of depression, the melancholic aspects of depression (non-interactiveness/motor retardation and agitation) lie at the severe end of the depressive continuum.
Highlights
Major depressive disorder (MDD) has increasingly been considered a multidimensional construct [1,2,3]
Several studies have recognized that depression is a multidimensional construct, the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression
A sample of 399 patients from a mood disorders outpatient unit was investigated with the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS), and the Core Assessment of Psychomotor Change (CORE)
Summary
Major depressive disorder (MDD) has increasingly been considered a multidimensional construct [1,2,3]. There are several studies investigating the dimensions underlying MDD using a variety of symptomatic scales and statistical methods [2, 5,6,7], evidence for the number and structure of depressive symptoms is still a matter of debate [5]. Theoretical and empirical views of MDD recognize the importance of multidimensionality for the depressive syndrome, available symptomatic scales might be limited in their ability to provide a proper multidimensional assessment because of their insufficient item content. Several studies have recognized that depression is a multidimensional construct, the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression. The objective of this study is to integrate information from instruments that measure depression from different perspectives–a self-report symptomatic scale, a clinician-rated scale, and a clinician-rated scale of depressive signs–in order to investigate the multiple dimensions underlying the depressive construct
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