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Antidepressants: Past, Present and Future pp 149–167Cite as

Quality of Life and Rating Scales of Depression

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 157))

Abstract

Rating scales for depression can be considered as the quantification of the symptoms included in the DSM-IV diagnosis of major depression. Among the essential psychometric properties of depression rating scales is their sensitivity to discriminate between antidepressants and placebo. Among the interview-based rating scales, the Hamilton Depression Rating Scale (HAM-D) is still the one most widely used. It is, however, not a unidimensional scale and the factors or dimensions of depression, anxiety and sleep should be analysed separately in drug trials. Among the self-rating scales, the coverage of major depression is insufficient in the most widely used scale, the Beck Depression Inventory. The scales based on DSM-IV, such as the Major Depression Inventory, should therefore be considered for use in future trials with antidepressants.

Quality of life scales are essentially self-rating scales as quality of life is a subjective dimension. Positive well-being is the core dimension of quality of life and can be considered the opposite pole to major depression. The most widely used quality of life scales are the Medical Outcome Studies (MOS) SF-36 and the Psychological General Well-Being Scale (PGWB). As a short, non-intrusive quality of life scale, the WHO-Five (which covers positive well-being items of the PGWB) should be considered in trials with antidepressants. However, the assessment of quality of life is also to be considered an attempt to see the whole of the patient when evaluating the outcome of treatment. Therefore, quality of life also covers coping skills and compliance in trials with antidepressants. The top-bottom approach of health-related quality of life in the psychopharmacological treatment of depressed patients encompasses the issues of impairments, disability, wanted and unwanted treatment effects, coping skills, compliance and subjective quality of life.

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  1. Psychiatric Research Unit, Frederiksborg General Hospital, 3400, Hillerød, Denmark

    P. Bech

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  1. Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine and Psychiatric Research Insitute, 1010 N. Kansas, Wichita, Kansas, 67214, USA

    Sheldon H. Preskorn

  2. Feighner Research Institute, 5230 Carrol Canyon Rd # 220, San Diego, CA, 92121, USA

    John P. Feighner (President and Director of Research) (President and Director of Research)

  3. W8057 Moonlite Road, Neillsville, WI, 54456, USA

    Christina Y. Stanga

  4. Ross Editorial, 228 Black Rock Mtn Ln, Independence, VA, 24348, USA

    Ruth Ross

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Bech, P. (2004). Quality of Life and Rating Scales of Depression. In: Preskorn, S.H., Feighner, J.P., Stanga, C.Y., Ross, R. (eds) Antidepressants: Past, Present and Future. Handbook of Experimental Pharmacology, vol 157. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18500-7_5

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