Psychometric evaluation of a 6-item Chinese version of the Hamilton Depression Rating Scale: Mokken scaling and item analysis.

Abstract

It is unclear whether the 6-item Melancholia subscale of the Hamilton Depression Rating Scale (HAM-D6 ) has better psychometric properties than the parental 17-item version (HAM-D17 ) in the Chinese populations. The study was to check the Chinese HAM-D17 and HAM-D6 for reliability and validity with Mokken scale analysis and item analysis. We reanalyzed a clinical sample of adult psychiatric outpatients (N=214; age, mean (SD)=38.3 (10.5) years; 63.1% female) in Taiwan. Our Mokken scale analysis showed that the HAM-D6 was a moderate unidimensional scale (Hs =0.44) while the HAM-D17 was not (Hs =0.26). The 5 items of the HAM-D6 had strong invariant item ordering (HT =0.58). The HAM-D17 and HAM-D6 had comparable reliability (α=0.79) and validity (r=0.91), and the HAM-D6 was more homogenous than the HAM-D17 . To predict depression in remission (HAM-D17 ≤7), the best cutoff of the HAM-D6 was 4 (specificity, 87.5%; sensitivity, 100%; positive predictive value, 56.0%; negative predictive value, 100%). The Chinese HAM-D6 was a reliable, valid, and unidimensional scale of depression.