Beck Depression Inventory Ratings Research Articles

Transdermal estradiol for postpartum depression: results from a pilot randomized, double-blind, placebo-controlled study.

Postpartum depression (PPD) is a common complication following delivery, though evidence-based treatment options are limited. This study explores the feasibility and efficacy of outpatient PPD treatment with transdermal estradiol (TE). In a pilot, double-blind, placebo-controlled trial, women with PPD were randomized to receive transdermal 17β-estradiol (100mcg/day) or placebo patch. Over 6weeks, women completed weekly ratings on the Beck Depression Inventory (BDI), Edinburgh Postnatal Depression Scale (EPDS), and Hamilton Depression Scale (HAM-D). Primary outcome measures were treatment response (> 50% decrease from baseline BDI) and remission (BDI < 10) at 6weeks, and secondary outcome measures included severity on all scales at weeks 3 and 6. Of 12 recruited women, 6 received TE and 6 received placebo. By week 6, 5 women receiving TE responded to treatment and 4 showed symptom remission, compared to 2 responders and 1 remitter in the placebo group. This difference was not significant (p = 0.24). In a mixed-model of BDI ratings, TE was associated with a 9.2 point decrease at 3weeks (95%CI - 19.5 to + 1.0, p = 0.074) and a 10.5 point decrease at 6weeks (95%CI - 21.0-0.0, p = 0.049) compared to placebo, though these differences did not survive multiple comparisons correction. Analogous effects were found for HAM-D but not EPDS scores. Interestingly, no significant difference in plasma estradiol levels existed between groups. We were unable to demonstrate a significant therapeutic benefit of TE compared with placebo in PPD. Although limited by under-recruitment and loss to follow-up, our results suggest TE is a feasible option for outpatient PPD management, with preliminary evidence (based on secondary outcomes) for efficacy. Therapeutic effects may be seen as early as 3weeks and may not directly depend on peripheral measures of estradiol.

Concurrent and Predictive Validity of the Adolescent Drug Abuse Diagno-sis (ADAD)

The concurrent and predictive validity of the Adolescent Drug Abuse Diagnosis (ADAD) in the Psychological status and problem area was examined for two adolescent groups: a non-clinical population of 121 Swedish adolescents (62 girls and 59 boys) aged 15 to17 years and a clinical population of 31 adolescents (14 girls and 17 boys) aged 12 to 19 years detained in special youth homes. Concurrent validity was demonstrated by significant correlations between the ADAD, Youth Self Report (YSR) and Beck Depression Inventory (BDI) scores. Findings regarding the predictive validity of ADAD show moderate associations with YSR, BDI and DICA problem ratings. The findings suggest that for clinical practice the ADAD Psychological status and problem area may be an appropriate assessment tool for measurement of cur-rent psychological problems. The utility obtained by making decisions using the test is substantial.

Severe Nightmares Linked to Suicide Risk

These authors tested 176 college-town psychiatric outpatients (mean age, 27) to determine whether self-ratings of insomnia, nightmare severity, and sleep-breathing disturbances were associated with four levels of thinking about killing oneself (from none to “I would . . . if I had the chance”) and with Beck Depression Inventory ratings. As …

Associations of the severity of depressive disorders in women with psychogenic low weight

Background: Depressive disorders are common in patients with anorexia nervosa (AN). Although depression with AN has been considered to be mainly secondary to the features of AN, other characteristics of such patients may also be causal, as personality disorders (PDs) often occur with AN and there are indications that PDs are causal factors for some depressive disorders. This study examined associations of the severity of depressive disorders in patients with low weight and a history of full or partial AN, to determine which characteristics of patients with AN are candidates as causal factors for depression in this context. Methods: 66 patients of a psychiatric ‘low-weight’ clinic completed self-report questionnaires. These patients presented with a mean body mass index (BMI) of 17.0 (S.D. 1.4) and their mean lowest BMI after the age of 16 had been 15.2 (S.D. 1.3). Results: Beck Depression Inventory (BDI) ratings were significantly associated with a range of eating disorder features (including age at presentation but not BMI) and with characteristics of a range of DSM-III-R PDs. Limitations: BDI ratings do not reflect clinical heterogeneity of depressive disorders, while self-report data for PD psychopathology can be subject to confounding variables. Conclusions: The results suggest that, first, features of AN (but not the degree of weight loss), and, second, psychopathology related to some features of all three DSM-III-R PD clusters may have causal roles in relation to depressive disorders in patients with AN and its variants. The findings indicate the need to consider a range of features of PDs in the management of patients with depression and AN.

Discrepancies between self and observer ratings of depression: The relationship to demographic, clinical and personality variables

Background: The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings. Method: The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory. Results: Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression. Limitations: The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies. Conclusions: Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.

Comparison of unlimited numbers of rapid transcranial magnetic stimulation (rTMS) and ECT treatment sessions in major depressive episode.

Repetitive transcranial magnetic stimulation (rTMS) is a new technology which holds promise as a treatment of psychiatric disorders. Most work to date has been on depression. Superiority to placebo has been indicated in three small blind studies. We compared the antidepressant effects of rTMS and ECT in 32 patients suffering major depressive episode (MDE) who had failed to respond to at least one course of medication. There was no limit to the number of treatment sessions which could be given and treatment was continued until remission occurred or response plateaued. A significant main effect for treatment type was found [Pillai trace = 0.248, F(3,28) = 3.076, p = 0.044; power = 0.656], reflecting an advantage for ECT patients on measures of depression overall, however, rTMS produced comparable results on a number of measures. Blind raters using the 17-item Hamilton Depression Rating Scale (HDRS) found the rate of remission (HDRS = ? 8) was the same (68.8%), and the percentage improvement over the course of treatment of 55.6% (rTMS) and 66.4% (ECT), while favouring ECT, was not significantly different. Significant differences were shown (p & 0.03) in percentage improvement on Beck Depression Inventory ratings (rTMS, 45.5%; ECT, 69.1%), but not for improvement in Visual Analogue ratings of mood (rTMS 42.3%; ECT, 57%). rTMS has antidepressant effects of useful proportions and further studies are indicated.

Hopelessness as a measure of suicidal intent in the depressed elderly.

Suicidal ideation in the elderly has been related to depression, changes in health, and anticipation of a limited future. The present study examined the Hopelessness Scale (HS) and its relation to these factors in a depressed geriatric population. A total of 120 elderly outpatients, who had applied to receive psychotherapy for depression, completed the HS, Beck Depression Inventory (BDI), health ratings, and the Schedule for Affective Disorder and Schizophrenia (SADS) at intake. The HS was found to be internally consistent, and a principal components analysis revealed three distinct factors that were related to hope, feelings of giving up, and future planning. The HS, BDI, and health ratings were predictive of suicidal ideation as measured by specific items in the SADS. The relation among suicidal ideation hopelessness, depression, and health perceptions for the depressed aged are discussed.

Correlates of self-reported and clinically assessed depression in outpatient alcoholics.

Used the Beck Depression Inventory (BDI) and Hamilton Psychiatric Rating Scale for Depression (Hamilton, 1960) to assess the levels of depression presented by 76 male and 29 female alcoholics. To estimate overall depression from the self-report and clinical instruments, the Z scores for both measures were summed. Correlations then were calculated between the composite scores and the alcoholics' background characteristics. Self-reported prior suicide attempts, severity of the current drinking problem, and being white were associated positively with depression. A stepwise multiple-regression analysis indicated that the self-reported occurrence of a prior suicide attempt was the only meaningful correlate. A combined cut-off score analysis of the BDI and Hamilton ratings indicated that 33.3% of the sample was moderately to severely depressed. The more depressed alcoholics were also more likely to have described previous suicide attempts.