Assessing anxious features in depressed outpatients

作者：McClintock Shawn M^*; Husain Mustafa M; Bernstein Ira H; Wisniewski Stephen R; Trivedi Madhukar H; Morris David; Alpert Jonathan; Warden Diane; Luther James F; Kornstein Susan G; Biggs Melanie M; Fava Maurizio; Rush A John

来源：International Journal of Methods in Psychiatric Research, 2011, 20(4): E69-E82.

DOI：10.1002/mpr.353

• depression
• anxiety
• rating scales
• STAR(star)D
• measurement-based care

Both the 17-item Hamilton Rating Scale for Depression (HRSD(17)) and 30-item Inventory of Depressive Symptomatology - Clinician-rated (IDS-C(30)) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric properties of the two anxiety subscales (HRSD(ANX) and IDS-C(ANX)) in a large sample (N = 3453) of outpatients with non-psychotic major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR(star)D) study. Approximately 48% of evaluable participants had at least one concurrent anxiety disorder by the self-report Psychiatric Diagnostic Screening Questionnaire (PDSQ). The HRSD(ANX) and IDS-C(ANX) were highly correlated (r = 0.75) and both had moderate internal consistency given their limited number of items (HRSD(ANX) Cronbach's alpha = 0.48; IDS-C(ANX) Cronbach's alpha = 0.58). The optimal threshold for ascribing the presence/absence of anxious features was found at a total score of eight or nine for the HRSD(ANX) and seven or eight for the IDS-C(ANX). It would seem beneficial to delete item 17 (loss of insight) from the HRSD(ANX) as it negatively correlated with the scale's total score. Both the HRSD(ANX) and IDS-C(ANX) subscales have acceptable psychometric properties and can be used to identify anxious features for clinical or research purposes.

• 出版日期2011-12