Self-rating Depression Scale Index Research Articles

Changes in serum levels of pain mediators in hemiplegic shoulder pain.

To provide a new insight into the diagnosis and treatment of hemiplegic shoulder pain (HSP) by investigating changes in serum pain mediators. Cross-sectional study. Shoulder pain group (n=34) and control group (n=21). Pain-free shoulder mobility, anxiety status, depression status, and shoulder pain were measured by passive range of motion (PROM), self-rating anxiety scale, self-rating depression scale (SDS), and visual analog scale, respectively. The enzyme-linked immunosorbent assay was used to test the serum pain mediators, including interleukin (IL)-1β, IL-2, IL-6, IL-10, nerve growth factor (NGF), tumor necrosis factor-α (TNF-α), substance P (SP), calcitonin gene-related peptide (CGRP), bradykinin (BK), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2), and lysophosphatidic acid (LPA). Shoulder pain group pain-free PROM significantly lower than control (p<.01), and SDS index score of shoulder pain group was significantly higher than control (p<.05). The rate of spasticity in the flexor elbow muscles is higher in shoulder pain group (p<.01). CGRP, IL-10, and IL-2 were significantly upregulated in shoulder pain group compared with control (p<.01), whereas NGF, TNF-α, IL-6, 5-HT, PGE2, SP, LPA, BK, and IL-1β were significantly decreased (p<.01). Patients with HSP have a higher risk of joint mobility disorders and depression; spasticity may be an important factor in the development of shoulder pain; CGRP is thought to be the major pain mediator in HSP, and HSP may not be inflammatory.

Changes in Anxiety and Depression After THA in Patients with Ankylosing Spondylitis and the Affecting Factors.

Hip ankylosis is a prevalent condition in patients with Ankylosing spondylitis (AS) that can significantly impact their psychological well-being. This study aimed to investigate the impact of Total Hip Arthroplasty (THA) on anxiety and depression among AS patients. 62 AS patients undergoing primary THA were recruited and separated into two groups based on preoperative hip motion. The 40 patients with hip mobility of 0° were assigned to group A, and others were assigned to group NA. Self-rating Anxiety Scale (SAS), Self-rating Depression scale (SDS), Harris hip scores (HHS) and 36-Item Short Form Survey (SF-36) were obtained one week before and there, six and twelve months after THA. The study found that AS patients in group A had significantly higher levels of anxiety and depression (SAS score = 75.05±2.79, SDS index score = 0.74±0.02) compared to group B (SAS score = 54.58±3.35, SDS index score= 0.64±0.03, P=0.01). However, both groups showed significant improvements in anxiety and depression scores from there to twelve months after THA (P<0.001). Correlation analyses revealed that the improvement in group NA was associated with hip pain relief (p<0.001), while the improvement in group A was related to joint function, disease duration, age at THA and spine imaging lesions (p<0.001). Some degree of anxiety and depression was present in both groups of AS patients. Levels of depression and anxiety were higher in patients with combined hip ankylosis. And their improvement was associated with improved hip function and quality of life after THA. Hip pain relief played a significant role in patients without hip joint ankylosis. The impact of the degree of lesion on spinal imaging on psychological status needs to be considered in both groups.

Effects of depression on cognitive function in patients with diabetes in different age groups

ABSTRACT Aims To investigate the effects of depression on cognitive function in patients of different ages with diabetes mellitus (DM). Methods 6,549 patients with DM who were assessed using the Mini-Mental State Examination (MMSE) and Self-Rating Depression Scale (SDS) in 2016 were selected from the 2016 Kailuan Group staff physical examinations. Generalized linear regression models were used to analyze the effects of SDS index score on MMSE score in DM patients in different age groups. We also analyzed the effects of SDS index score on MMSE score in DM patients with different risk factors. Results Generalized linear regression analysis showed that higher SDS index score was associated with lower MMSE score (β = −0.06; P < 0.01). In addition, there was an interaction effect between SDS index score and age groups on cognitive function. Meanwhile, SDS index score also has an interaction effect with level of education. Conclusions The negative association between the degree of depression and cognitive function level increases with age in DM patients.

Analysis of Factors Affecting Psychological Resilience of Emergency Room Nurses Under Public Health Emergencies.

Resilience is essential for frontline health workers to cope with the unfavorable situations, especially under public health emergencies. Emergency room (ER) nurses are a special cohort of health professionals that may present moderate level of resilience. This study aimed to identify factors that are correlated with resilience in this special cohort to provide directions for intervention and management. ER nurses that have encountered a public health emergency within 3 months were recruited using purposive sampling and snowball technique for the study. Questionnaires, including Connor-Davidson Resilience Scale (CD-RISC), Zung Self-Rating Depression Scale (SDS), and Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were established, followed by an in-depth interview to identify different clusters of themes. Thirteen ER nurses were recruited, and the average CD-RISC score was 66 ± 21. Resilience was negatively correlated with SDS index, and positively correlated with personal accomplishment. Five clusters of themes were identified from in-depth interviews, including physical tolerability, psychological tolerability, tenacity of internal drive, institutional implementation, and external adjustment. This study identified factors associated with resilience in ER nurses under public health emergencies, providing useful information for future directions for intervention.

LINKAGE AND SPILLOVER EFFECTS OF CHINA'S CARBON MARKET AND STOCK MARKET UNDER THE BACKGROUND OF CARBON NEUTRALITY: AN ANALYSIS BASED ON INVESTOR SENTIMENT REGULATION

LINKAGE AND SPILLOVER EFFECTS OF CHINA'S CARBON MARKET AND STOCK MARKET UNDER THE BACKGROUND OF CARBON NEUTRALITY: AN ANALYSIS BASED ON INVESTOR SENTIMENT REGULATION

Effect of daily tadalafil on reported outcomes in patients with erectile dysfunction and depressive symptoms: STROBE, a case-control study.

Erectile dysfunction (ED) and depression are closely related. We sought to determine ED and depression were improved by tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, at 5 mg daily, in this case–control study.Participants were men aged 20 to 65 years with ED for >3 months, International Index of Erectile Function-5 (IIEF) score <21 points, and Zung Self-Rating Depression Scale (SDS) survey result >50 points who were willing to participate.On first visit (V1) and after 1 (V2) and 2 months (V3), clinical features were examined using IIEF-5 for diagnosing and evaluating ED, SDS for evaluating depression, and International Prostate Symptom Score and Quality of Life (IPSS/QoL) survey for examining lower urinary tract symptoms (LUTS). Tadalafil 5 mg was administered daily for 2 months.A total of 60 participants were an average age of 58.68 ± 6.71 years. Patient overall average IIEF was 8.76 ± 5.98, showing mild ED symptoms, and total average IPSS 13.74 ± 7.55 showed moderate LUTS. Average overall SDS index was 58.93 ± 9.21, indicating moderate-to-severe findings. Average change in IIEF among all patients revealed significant improvement from V1 to V2 (−2.69 ± 1.22, P = .03) and V1 to V3 (−4.38 ± 1.20, P < 0.01). IPSS also significantly improved from V1 to V3 (3.48 ± 1.37, P = .01), as did SDS index (V1, V2: 4.69 ± 1.89, P = 0.02), (V1, V3: 5.43 ± 1.89, P < .01). Patients with severe IIEF scores (group 1, n = 27) experienced significantly greater improvement in IIEF from V1 to V2 and V1 and V3, compared to those with mild-to-moderate IIEF scores. Both groups improved in SDS index from V1 to V2 and V1 to V3, with the greatest improvement between V1 and V3 for group 1 and V1 and V2 for group 2.Daily tadalafil 5 mg could be helpful for ED patients with depressive symptoms and improved LUTS and quality of life.

A study of sociocultural factors on depression in Chinese infertile women from Hunan Province

Objective: To explore the sociocultural factors influencing depression in Chinese infertile women in Hunan Province.Methods: A cross-sectional study was carried out. A total of 211 Chinese infertile women completed demographic details, a disease-related information questionnaire, a self-rating depression scale (SDS) and a social support rating scale (SSRS).Results: One hundred and seven (50.71%) of the participants were classified as depressed according to the self-rating depression scale. The average SDS index score was 50.06 ± 10.59. Using analysis of variance (ANOVA), Pearson correlation and a multivariable regression analysis, the results showed family type, feelings of discrimination, social support, feelings of shame and reproductive pressures were influential factors in depression among Chinese infertile women.Conclusion: Sociocultural factors influence depression levels in Chinese female infertile patients. The unique aspects of Chinese culture may have a negative mental impact on the patients, and cultural factors should be taken into consideration in the development of coping strategies for Chinese infertile women.

Depression and Outcomes in Hospitalized Japanese Patients With Cardiovascular Disease - Prospective Single-Center Observational Study -

Several studies have suggested that depression poses a risk in cardiovascular patients. The aim of the present study was to evaluate the prevalence of depression and its effect on cardiovascular events and mortality in Japanese inpatients with cardiovascular disease. A total of 505 patients hospitalized with cardiovascular disease (28% female; mean age, 61 ± 14 years; 31% ischemic heart disease; 47% New York Heart Association [NYHA] class II-IV; 25% implantation of pacing devices) were enrolled in the present prospective observational study. The Zung Self-Rating Depression Scale (SDS) was used to screen for depression. The primary outcome was the time to death or cardiovascular event, and the secondary outcome was death. In total, 109 patients (22%) were diagnosed with depression (Zung SDS index score ≥ 60). NYHA class III/IV, defibrillator implantation, and being unmarried were independently associated with depression. During an average follow-up period of 38 ± 15 months, 92 patients (18%) reached the primary outcome. There was a higher incidence of the primary outcome in patients with depression than in those who were not depressed (P<0.01). Depressed patients had a significantly higher rate of mortality than non-depressed patients (P<0.01). Depression was an independent predictor of the primary outcome (hazard ratio, 2.25; 95% confidence interval: 1.30-3.92, P<0.01). Depression was not uncommon in Japanese inpatients with cardiovascular disease and was associated with cardiovascular outcomes.

Prevalence and Persistence of Depression in Patients with Implantable Cardioverter Defibrillator: A 2‐year Longitudinal Study

It is unclear whether depression persists in patients with implantable cardioverter defibrillators (ICDs). We evaluated the prevalence and persistence of depression in ICD patients over a 2-year period. The study included 90 consecutively hospitalized patients. Patients underlying heart disease was 24% coronary artery disease, 29% idiopathic dilated cardiomyopathy, 24% hypertrophic cardiomyopathy, 13% idiopathic VF/long QT syndrome and miscellaneous conditions 11%. A secondary indication for ICD implantation was present in 20 patients. All patients completed the Zung Self-Rating Depression Scale (SDS) at study baseline and at the their routine follow-up visit 2 years after the baseline questionnaire. Delivery of ICD therapies was tracked throughout the 2 years. Depression, indicated by a Zung SDS index score exceeding 60, was present in 29 (32%) of patients at study baseline. Depression was present in 11/51 (21%) patients scheduled to undergo ICD implantation, 2/2 (100%) patients whose device was upgraded to a CRT-D, 3/14 (21%) patients who had undergone pulse generator replacement, 7/14 (50%) patients who experienced electrical storm and 6/9 (66%) patients hospitalized with acute decompensated heart failure. NYHA functional class III was significantly associated with depression at baseline (HR 6.7, 95% CI 1.68-27.2, p = 0.0007). No differences were noted for female gender, demographics, β-blocker use, or LVEF ≤35% (p = ns). Depression was present in 25 (28%) of patients at 2 years follow-up, persisting in 21 (72%) of patients whose Zung SDS scores were elevated at baseline. The median time from ICD shock therapy to completion of the 2 year questionnaire was 9 months (range, 1-22). Patients who were depressed (9/25, 36%) experienced more shocks than non-depressed patients (6/65, 9%) after 2 years (p = 0.002). Depression is not uncommon among patients who meet criteria for ICD implantation and persists over time particularly when functional status is impaired. Depression is associated with a higher incidence shock therapy.

Validity of a Brazilian version of the Zung self-rating depression scale for screening of depression in patients with Parkinson's disease

Introduction Parkinson's disease (PD) is a neurodegenerative disorder with prominent motor manifestations and many other non-motor symptoms that significantly decrease quality-of-life and are frequently under-recognized, for example depression. Objective To study the validity of a Brazilian version of the Zung Self-rating Depression Scale (SDS) for the diagnosis of depression in patients with PD. Methods We evaluated 78 consecutive non demented patients over the age of 40 with diagnosis of PD at a Movement Disorders Outpatient Clinic, who could read and understand questionnaires. They completed the SDS and the Geriatric Depression Scale with 15 items (GDS-15). The diagnosis of depression was made after a structured clinical interview based on DSM-IV criteria for the diagnosis of major depression (SCID-CV). Results The prevalence of major depression was 23.1%. Cronbach's alpha was 0.73 and the area under the ROC curve was 0.93 for the SDS. The score index of 55 had a sensitivity of 88.9% and a specificity of 83.3% for the diagnosis of depression. The total scores of the SDS and GDS-15 were highly correlated (0.652, p < 0.0001) and correlated weakly with the scores of a motor scale. Discussion The SDS is a valid tool for screening depression in patients with PD since the specific SDS index of 55 is adopted. Two shortened versions could be used with good results.

Promoter Polymorphisms of the Interferon-α Receptor Gene and Development of Interferon-Induced Depressive Symptoms in Patients with Chronic Hepatitis C: Preliminary Findings

Background: Interferon (IFN)-α treatment frequently induces depression, which can impair quality of life and reduce treatment adherence. Defining relevant risk factors for IFN-α-induced depression is essential for designing preventative treatment strategies. Objective: The purpose of the present study was to determine whether promoter polymorphisms of –408C/T, –3C/T and GT repeat dinucleotide microsatellite in the IFN-α/β receptor 1 (IFNAR1) gene are associated with the development of IFN-induced depression. Method: Fifty patients with chronic hepatitis C were treated with pegylated IFN α-2b plus a standard or weight-based dose of ribavirin. Severity of depression was assessed using the Zung Self-Rating Depression Scale (SDS) at baseline and at 4, 8, 12 and 24 weeks of treatment. Result: The baseline to maximum difference in the SDS index score of neurovegetative/somatic symptoms was higher in patients with the 5/14 genotype of the GT repeat dinucleotide microsatellite polymorphism than in those patients with other genotypes (p = 0.0084). Conclusion: This preliminary result suggests that the promoter GT repeat dinucleotide microsatellite polymorphism of the IFNAR1 gene may represent a risk factor for the development of depressive symptoms during IFN-α therapy for hepatitis C and other conditions.

Depressive symptoms and viral clearance in patients receiving interferon-α and ribavirin for hepatitis C

Interferon (IFN)-α plus ribavirin is an effective treatment for hepatitis C virus (HCV) infection, but is associated with a high rate of depression. Depression has been linked to a worse outcome in multiple medical disorders including viral illnesses. We examined whether increased symptoms of depression during IFN-α/ribavirin therapy were associated with a reduced treatment response as assessed by clearance of HCV. Depressive symptoms were evaluated in 102 HCV-infected patients at baseline and after 4, 8, 12, and 24 weeks of pegylated IFN-α-2b plus ribavirin therapy using the Zung self-rating depression scale (SDS). Viral clearance was determined at 24 weeks by polymerase chain reaction (PCR). Only 34% of subjects (10 out of 29) with a 20-point or greater increase in SDS Index score were HCV PCR negative at 24 weeks, compared to 59% (24 out of 41) of patients with a 10–19 point increase in SDS Index and 69% (22 out of 32) of patients with a less than 10 point increase ( χ 2=7.6, df=2, p<0.05). In addition, a 20-point or greater increase in SDS Index score during IFN-α/ribavirin therapy significantly predicted failure to clear virus when considered alone [crude odds ratio (OR), 3.2; 95% confidence interval (CI), 1.3–8.0; p<0.01] or when controlling for other factors that affected IFN-α treatment response (adjusted OR, 3.6; 95% CI, 1.3–9.5; p=0.01). These preliminary findings suggest that individuals who experience significant increases in depressive symptoms during IFN-α/ribavirin therapy may be less likely to clear virus, highlighting the importance of identifying and treating depressive symptoms in this patient population.

Effects of depression on parameters of cell-mediated immunity in patients with digestive tract cancers.

To evaluate the effects of depression on parameters of cell-mediated immunity in patients with cancers of the digestive tract. One hundred and eight adult patients of both sexes with cancers of the digestive tract admitted between March 2001 and February 2002 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. The Zung self-rating depression scale (SDS), Zung self-rating anxiety scale (SAS), numeric rating scale (NRS) and social support rating scale (SSRS) were employed to evaluate the degree of depression and their contributing factors. In terms of their SDS index scores, the patients were categorized into depression group (SDS> or =50) and non-depression group (SDS<50). Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared between the two groups of patients. The SDS index was from 33.8 to 66.2 in the 108 cases, 50% of these patients had a SDS index more than 50. Similarly, the SAS index of all the patients ranged from 35.0 to 62.0 and 46.3% of the cases had a SAS index above 50. Cubic curve estimation showed that the depression was positively correlated with anxiety and negatively with social support. Furthermore, the depression correlated with the tumor type, which manifested in a descending order as stomach, gallbladder, pancreas, intestine, esophagus, duodenum and rectum, according to their correlativity. Step-wise regression analysis suggested that hyposexuality, dispiritment, agitation, palpitation, low CD56 and anxiety were the significant factors contributing to depression. More severe anxiety (49.7 +/- 7.5 vs 45.3 +/- 6.9, P<0.05), pain (6.5 +/- 2.8 vs 4.6 +/- 3.2, P<0.05), poor social support (6.8 +/- 2.0 vs 7.6 +/- 2.1, P<0.05), as well as decline of lymphocyte count (0.33 +/- 0.09 vs 0.39 +/- 0.87, P<0.05) and CD56 (0.26 +/- 0.11 vs 0.29 +/- 0.11, P<0.05) were noted in the depression group compared with those of the non-depression patients. However, fewer obvious changes in CD4/CD8 ratio and other immunological parameters were found between the two groups. Depression occurs with a high incidence in patients with cancers of the digestive tract, which probably is not the sole factor leading to the impairment of immunological functions in these cases. However, comprehensive measures including psychological support should be taken in order to improve the immunological function, quality of life and clinical prognosis of these patients.

Depressive symptoms during and after radiotherapy for head and neck cancer.

Patients with head and neck cancer are extraordinarily susceptible to depressive traits. Thus, a general screening of these patients at their first admission to the ital is desirable. From 1997-2001, 133 patients with head and neck tumors filled in the Self-Rating-Depression-Scale (SDS) at the beginning and end of radiotherapy (ti1/ti2), 6 weeks, and 6 months after radiotherapy (ti3/ti4). RESULTS.: The SDS index increased significantly from 46.44 (ti1) to 48.91(ti2) (p =.025) and then remained stable. The subdomain "somatic-eating-related symptoms" at ti1 was significantly lower than ti2 (p <.001). In contrast to inpatients, outpatients and those with conventional instead of hyperfractionated-accelerated radiotherapy were less impaired by eating-related symptoms. Patients with higher education showed a lower SDS index and cognitive scale. Marital status, tumor stage, histologic grading, and substance abuse had no influence. Patients with a higher risk of depression should receive long-term monitoring during and after the end of radiotherapy, and prompt intervention strategies should be applied.

Depressive reactions to lung cancer are common and often followed by a poor outcome.

In diverse human malignancies, including lung cancer, quality of life (QOL) affects the clinical outcome of patients. Many QOL dimensions, however, are influenced by physical status. The current study was undertaken to delineate the role of depression, a state of mind not necessarily influenced by somatic factors. All patients, seen for a newly diagnosed carcinoma of the lung, received a copy of the Self-rating Depression Scale (SDS) proposed by W.W.K. Zung. One hundred and thirty three patients were able and willing to complete the questionnaire. A depression index was calculated, as originally described. Nineteen other prognostically important variables were recorded and available for evaluation. Among the 95 patients who completed all 20 items included in the questionnaire, 53 had an SDS index < or = 50 (no depression), while 42 were moderately or severely depressed (SDS index >50). The survival of depressed patients was significantly lower (p=0.048). Diverse SDS subscales were associated with survival, in either univariate or multivariate analysis. SDS item 19, "I feel that others would be better off if I were dead", emerged as the most significant one. A multivariate model of survival, constructed using only SDS data, had a global Chi-squared value of 29.78, and a p-value of 0.00023. Based on this evidence, it appears that a relationship does exist between patients' depression and prognosis, at least in lung cancer. Further studies are needed to clarify the prognostic effect of depression in more specific (and homogeneous) subgroups of patients.

Factor structure of self-rating depression scale by Zung and prevalence of depressive state of night shift workers.

The Zung self-rating depression scale (SDS) was applied to Japanese night shift workers of a railway company in order to assess the prevalence of depressive state and clarify the structural characteristics of the SDS questionnaire. Out of 2,394 employees, 1,931 male workers were engaged in night shift work and 1,274 men (66.0%) completely answered the questionnaire. The control group was selected from daytime workers. The average age of the subjects was 39.4. Cronbach's alpha coefficient of the night shift workers was 0.835 and that of the control was 0.848. SDS index decreased with age. The mild, moderate, and severe depressive state of night shift workers evaluated by SDS were 13.7%, 2.1%, and 0.6%, respectively. A two-way analysis of variance on SDS index examined age and shift work. Age influenced SDS index, but there was no interaction between the factors. Two factors were extracted by factor analysis. Factor 1 consisted of 8 positive items, accounting for 16.7%. Factor 2 consisted of 8 depressive items, accounting for 15.6%. The residual four items consisted of somatic or behavioral features. Mean value of SDS index by age, distribution of SDS index, and factor structure of SDS questions of the night shift workers were similar to those of the control group.

Prevalence of depressive symptoms among patients attending a general outpatient clinic.

Using both the English version and an Igbo translation of Zung's Self-rating Depression Scale (SDS), 132 first-time attenders to a hospital-based general outpatient clinic were screened for presence of depressive symptoms. The mean SDS index obtained for the whole sample fell within the normal range. However, a prevalence rate of 25% for depressive symptoms was obtained. 14% scored within the range for "mild depression", while 11% obtained scores within the range for "moderate depression". Only three patients were referred to the psychiatric outpatient clinic of the same hospital. The need for general physicians to be able to recognise the presence and significance of psychological symptoms in their patients is emphasized.

Response set on the Zung Self-Rating Depression Scale.

The Zung Self-rating Depression Scale (SDS) is a brief personality inventory designed to assess depression (Zung, 1965 ) . SDS scores are not significantly correlated with age, sex, intelligence, marital starus, financial starus, or educational level (Zung, 1967) , bur are with other inventories designed to measure depression such as the D scale of the MMPI (Zung, Richards, & Short, 1965) and the Depression Adjective Check List (Marone & Lubin, 1968) . The present authors found that Ss could fake bad on the SDS but could not significantly fake good (Mikesell & Calhoun, 1969) . Generally, response set may be defined as the tendency to respond in a particular way, almost independently of item content. The present srudy attempted to examine the SDS for the response set, effects. Order effects refer to Ss' tendency to respond to related items of a personality inventory in one way when the items are clustered (e.g., related items presented together) and in another way when these related items are not clustered (e.g., items presented in random order). For example, Greenberg and Frank (1965) found such response set operant in the Tennessee Self-concept Scale. The SDS is composed of items designed to assess three areas of depressive symptoms: pervasive affect, psychological equivalents, and physiological equivalents. The items for each of these three symptom areas are presented together rather than being presented in random order. Therefore, order effects would be demonstrated i f Ss responded one way to a random ordering of SDS items and in another way to the standard ordering of the SDS items. The present study was designed to assess the effect of the order of items on total scores on the SDS. Ss, who were 6 0 female high school seniors, were randomly assigned to one of two groups. Group I (control) was administered the standard form of the SDS and Group I1 a form wherein the 20 items were arranged in random order. The raw scores on the SDS are converted into the SDS Index. Group I (standard order) obtained a mean score of 38.1 and an S D of 6.20. Group I1 (scrambled order) obtained a mean score of 40.70 and an S D of 7.68 ( t = 1.44, n.s.). Thus, there are no significant order effects on the SDS. Total scores obtained on the SDS appear not to be influenced by the standard clustering of items according to symptom categories, suggesting again (Mikesell & Calhoun, 1969; Zung, 1965, 1967) that the self-report inventory is relatively useful and reliable. REFERENCES GREENBERG, G. U., & FRANK, G. H. Response set in the Tennessee Department of Mental Health Self Concept Scale. Jorrrnal o f Clinical Psychology, 1965, 21, 287-288. MARONE, J . , & LUBIN, B. Relationship becween set 2 of the Depression Adjective Check List (DACL) and Zung Self-rating Depression Scale (SDS) . Psychological Reports, 1968, 22, 333-334. MIKESELL, R. H., & CALHOUN, L. G. Faking on the Zung Self-rating Depression Scale. Psychological Reports, 1969, 2 5 , 173-174. Z ~ G , W. W. K. A Self-rating Depression Scale. Archives o f General Psychiatry, 1965, 12, 63-70. ZUNG, W. W. K. Factors influencing the Self-rating Depression Scale. Archives o f General Psychiatry, 1967, 16, 543-547. ZUNG, W. W. K., RICHARDS, C. B., & SHORT, M. J. Self-rating Depression Scale in an outpatient c l~nic : further v a l ~ d a t ~ o n of the SDS. Archives o f General Psychiatry, 1965, 13, 508-515. Accepted December 2, 1969.