A comparison of alternative assessments of depressive symptom severity: a pilot study

Early Pubertal Timing and Childhood Family Adversity Interact to Predict Newlywed Women's Anxiety Symptoms

The contextual amplification hypothesis posits that girls' early pubertal timing will predict anxiety and depression symptoms most strongly when early puberty occurs under adverse conditions. Research supporting this hypothesis has consistently linked early pubertal timing occurring in adverse contexts to symptoms during adolescence, but little is known about the link to adult symptoms. The present study examined the extent to which women's reports of early pubertal timing and childhood family adversity interact to predict symptoms of anxiety and depression during the first two years of marriage. Married women (N = 226) completed questionnaires within 7 months into their first marriage (Time 1) and approximately 19 months later (Time 2). Analyses indicated that at both Time 1 and 2, women's reports of earlier pubertal timing predicted anxiety symptoms only when women reported a history of greater childhood family adversity. Additional analyses indicated that the interaction of earlier pubertal timing and greater childhood family adversity predicted symptoms of traumatic intrusions and panic, but not social anxiety, at Time 1, and panic symptoms at Times 1 and 2. These findings expand our understanding of the relation of early pubertal timing to adult emotional health and the family conditions that moderate this relation.

Psychometrics and latent structure of the IDS and QIDS with young adult students

BACKGROUND

Students and young adults have high rates of suicide and depression, thus are a population of interest. To date, there is no normative psychometric information on the IDS and QIDS in these populations. Furthermore, there is equivocal evidence on the factor structure and subscales of the IDS.

METHODS

Two samples of young adult students (ns=475 and 1681) were given multiple measures to test the psychometrics and dimensionality of the IDS and QIDS.

RESULTS

The IDS, its subscales, and QIDS had acceptable internal consistencies (αs=.79-90) and favorable convergent and divergent validity correlations. A three-factor structure and two Rasch-derived subscales best fit the IDS.

LIMITATIONS

The samples were collected from one university, which may influence generalizability.

CONCLUSIONS

The IDS and QIDS are desirable measures of depressive symptoms when studying young adult students.

Feasible evidence-based strategies to manage depression in primary care

According to the World Health Organization, major depressive disorder (MDD) is a leading cause of disability-adjusted life years worldwide. However, recent evidence suggests depression remains undertreated in primary care settings. Measurement-based care (MBC) is an evidence-based strategy that can feasibly assist primary care physicians in managing patients with MDD. Utilizing health information technology tools, such as computer decision support software, can improve adherence to evidence-based treatment guidelines and MBC at the point of care.

Personality traits and the reporting of affective disorder symptoms in depressed patients

BACKGROUND

A deeper understanding of the influences on self-reported mood symptoms could inform the debate about the utility of self-report instruments and enhance the assessment and treatment of affective disorders. We tested the hypotheses that higher Neuroticism is associated with the over-reporting of affective symptoms and lower Openness to Experience is associated with the under-reporting of affective symptoms.

METHODS

Subjects were 134 inpatients of ages 50 and over diagnosed with a mood disorder. Personality was assessed with the Revised NEO Personality Inventory. Self-reported depression was assessed with the Beck Depression Inventory-II; observer-rated depression was assessed via the Hamilton Depression Rating Scale. Symptom-reporting was defined as the ratio of self-reported to observer-rated symptoms.

RESULTS

As hypothesized, multivariate linear regression analyses revealed that high Neuroticism contributed to patients' over-reporting of mood symptoms. Contrary to the hypothesis, low Openness was associated with high ratios of self-reported to observer-rated mood symptoms.

LIMITATIONS

Cross-sectional design and unclear generalizability to racial/ethnic minorities.

CONCLUSIONS

Traits are important correlaters of self-reported vs. observer-rated symptoms in patients with affective disorders. To the extent that economic imperatives and other pressures impel greater reliance on self-report data in mental health research and services, there will be a corresponding need for prospective research on the determinants and clinical implications of discrepancies between self-reports and observer ratings.

Clinician ratings vs. global ratings of symptom severity: a comparison of symptom measures in the bipolar disorder module, phase II, Texas Medication Algorithm Project

This study compares ratings obtained with an itemized, clinician-rated, symptom severity measure--the 24-item Brief Psychiatric Rating Scale (BPRS(24))--to a Physician Global Rating Scale (PhGRS), a Patient Global Rating Scale (PtGRS) and the clinician-completed Multnomah Community Ability Scale (MCAS) in patients with bipolar disorder (BPD). A total of 69 patients (25 inpatients and 44 outpatients) with BPD were enrolled in a feasibility study of the use of medication algorithms in the treatment of BPD. Clinicians at each visit completed the BPRS(24), PhGRS and MCAS, and patients completed the PtGRS. Analyses compared the BPRS(24) and BPRS subscales with the PtGRS, PhGRS and MCAS. PtGRS scores correlated poorly with BPRS(24) and with PhGRS scores at baseline, although PtGRS change scores correlated moderately with BPRS(24) change scores. Baseline BPRS(24) and PhGRS scores correlated moderately at baseline with somewhat stronger correlations found on change scores for the two measures. MCAS scores showed moderate correlations with BPRS(24) scores both at baseline and with change over time. Global assessments by patients or physicians only moderately or poorly reflected BPRS(24) scores. Itemized symptom measures to gauge severity of illness or change over time are preferred over patient or physician global judgments.