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Psychometric analysis of the Melancholia Scale in trials with non-pharmacological augmentation of patients with therapy-resistant depression

Published online by Cambridge University Press:  08 October 2013

Per Bech ,
Lise Lauritzen ,
Marianne Lunde ,
Mogens Unden ,
Lone Christina Hellström ,
Claudio Csillag  and
Klaus Martiny
Per Bech*
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lise Lauritzen
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Marianne Lunde
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Mogens Unden
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lone Christina Hellström
Affiliation:
Psychiatric Research Unit, Psychiatric Centre Bispebjerg, Copenhagen University Hospital, Copenhagen, Denmark
Claudio Csillag
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Klaus Martiny
Affiliation:
Psychiatric Department O, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
*
Per Bech, Psychiatric Research Unit, Psychiatric Centre North Zealand, University of Copenhagen, Dyrehavevej 48, DK-3400 Hillerød, Denmark. Tel: +45 38 64 30 95; Fax: +45 48 26 38 77; E-mail: Per.bech@regionh.dk
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Abstract

Objective

The Melancholia Scale (MES) consists of the psychic core items of the Hamilton Depression Scale (HAM-D6) (depressed mood, interests, psychic anxiety, general somatic, guilt feelings, and psychomotor retardation) and the neuropsychiatric items of the Cronholm–Ottossen Depression Scale. Patients resistant to anti-depressant medication (therapy-resistant depression) have participated in our trials with non-pharmacological augmentation. On the basis of these trials, we have evaluated to what extent the neuropsychiatric subscale of the MES (concentration difficulties, fatigability, emotional introversion, sleep problems, and decreased verbal communication) is a measure of severity of apathia when compared with the HAM-D6 subscale of the MES.

Methods

We have focused on rating sessions at baseline (week 0) and after 2 and 4 weeks of therapy in four clinical trials on therapy-resistant depression with the following augmentations: electroconvulsive therapy, bright light therapy, transcranial magnetic stimulation or pulsed electromagnetic fields, and wake therapy. The item response theory model constructed by Mokken has been used as the psychometric validation of unidimensionality. For the numerical evaluation of transferability, we have tested item ranks across the rating weeks.

Results

In the Mokken analysis, the coefficient of homogeneity was above 0.40 for both the HAM-D subscale and the apathia subscale at week 4. The numerical transferability across the weeks was statistically significant (p < 0.05) for both subscales.

Conclusion

The apathia subscale is a unidimensional scale with acceptable transferability for the measurement of treatment-resistant symptoms, analogue to the psychic core subscale (HAM-D6).

Keywords

mood disorderspsychiatric status rating scalespsychometrics
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 26 , Issue 3 , June 2014 , pp. 155 - 160
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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