Measurement of mania and depression (original) (raw)
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Comparative evaluation of two self-report mania rating scales
Biological Psychiatry, 1996
Inventory (SRMI), have been shown to reliably diagnose mania. In the current study we further evaluated the utility of these scales relative to each other and to the observer-rated Young Mania Rating Scale (YMRS), for quantifying the severity of manic/hypomanic symptoms cross-sectionally and over time, in 20 patients with rapid-cycling bipolar disorder. The self-report scales correlated well with each other and with the YMRS, but each covered a somewhat different domain of the manic syndrome. The SRMI and the ISS were more sensitive than the YMRS to the mood fluctuations in the euthymic to hypomanic range observed in our subjects. Used in tandem, the two self-report scales may find application in clinical research with outpatients with bipolar disorder, and as an adjunct to clinical monitoring in this patient population.
An item response theory evaluation of three depression assessment instruments in a clinical sample
BMC Medical Research Methodology, 2012
Background: This study investigates whether an analysis, based on Item Response Theory (IRT), can be used for initial evaluations of depression assessment instruments in a limited patient sample from an affective disorder outpatient clinic, with the aim to finding major advantages and deficiencies of the instruments. Methods: Three depression assessment instruments, the depression module from the Patient Health Questionnaire (PHQ9), the depression subscale of Affective Self Rating Scale (AS-18-D) and the Montgomery-Åsberg Depression Rating Scale (MADRS) were evaluated in a sample of 61 patients with affective disorder diagnoses, mainly bipolar disorder. A '3step IRT strategy' was used.
Psychometric considerations of depression symptom rating scales
Neuropsychiatry, 2011
Psychometric considerations of depression symptom rating scales Practice points Depression is a condition that is inferred from its symptoms and signs rather than a condition that can be observed directly such as a fracture, elevated body temperature or blood pressure. As such, depression can be viewed as a latent variable, inferred variable or construct rather than an observable variable. Latent variables have been commonly studied in psychometrics using what is known as classical test theory. More recently, various forms of modern test theory, in particular item response theory (IRT), have proven particularly useful in articulating features of tests used to infer depression. An IRT model developed by Samejima is particularly useful with polytomous (multipoint) scales, such as Likert scales, as opposed to scales that use binary responses. One of the several useful aspects of IRT is that it can be used to equate scales (i.e., provide a formal basis for saying that a score of X on test A corresponds to a score of Y on test B). This paper contrasts various scales used to infer depression with regard to their internal properties such as reliability and dimensionality. A key point is that reliability and related statistics are a function of the sample in which they are inferred (i.e., there is no such thing as 'the reliability of test X'). Although it is important to ensure that the various scales measure depression in a meaningful sense, their results are more similar than different because of their similar item content. Because of this and space limitations, we will not be concerned with this issue of validity.
Item Response Analysis of the Inventory of Depressive Symptomatology
Neuropsychiatric disease and treatment, 2006
BACKGROUND: Both the clinician (IDS-C(30)) and self-report (IDS-SR(30)) versions of the 30-item Inventory of Depressive Symptomatology have acceptable psychiatric properties and have been used in various clinical studies. These two scales, however, have not been compared using item response theory (IRT) methods to determine whether the standard scoring methods are optimal. METHODS: Data were derived from 428 adult public sector outpatients with nonpsychotic major depressive disorder. The IDS-C(30) and IDS-SR(30) were compared using Samejima's graded response model. RESULTS: A model was constructed jointly fitting the IDS-C(30) and IDS-SR(30). An improvement in scale performance was obtained by grouping selected items into domains (specifically sleep, psychomotor, and appetite/weight domains) analogous to the standard scoring of the 16-item Quick Inventory of Depressive Symptomatology. CONCLUSIONS: For the IDS-C(30) and IDS-SR(30), standard scoring (ie, computing total score usin...
The Altman Self-Rating Mania Scale
Biological Psychiatry, 1997
We report on the development, reliability, and validi O, of the Altman Self-Rating Mania Scale (ASRM). The ASRM was completed during medication washout and after treatment by 22 schizophrenic, 13 schizoaffective, 36 depressed, and 34 manic patients. The Clinician-Administered Rating Scale for Mania (CARS-M) and Mania Rating Scale (MRS) were completed at the same time to measure concurrent validi~'. Test-retest reliabili~' was assessed separately on 20 depressed and ]0 manic" patients who completed the ASRM twice during washout. Principal components analysis of ASRM items revealed three .factors." mania, psychotic symptoms, and irritability. Baseline mania subscale scores were significantly higher for manic patients compared to all other diagnostic groups. Manic patients had significantly decreased posttreatment scores for all three subscales. ASRM mania subscale scores were significantly correlated with MRS total scores (r := . 718) and CARS-M mania subscale scores (r = .766). Test-retest reliability for the ASRM was significant for all three subscales. Significant differences in severi~' levels were fi)und fi)r some symptoms between patient ratings on the ASRM and clinician ratings on the CARS-M. Mania subscale scores of greater than 5 on the ASRM resulted in values of 85.5% fbr sensitivity and 87.3%for specificity. Advantages of the ASRM over other self-rating mania scales are discussed.
Item response modeling of DSM-IV mania symptoms in two representative US epidemiological samples
Psychological medicine, 2010
There is considerable debate surrounding the effective measurement of DSM-IV symptoms used to assess manic disorders in epidemiological samples. Using two nationally representative datasets, the National Epidemiological Survey of Alcohol and Related Conditions (NESARC, n=43,093 at wave 1, n=34,653 at 3-year follow-up) and the National Comorbidity Survey - Replication (NCS-R, n=9282), we examined the psychometric properties of symptoms used to assess DSM-IV mania. The predictive utility of the mania factor score was tested using the 3-year follow-up data in NESARC. Criterion B symptoms were unidimensional (single factor) in both samples. The symptoms assessing flight of ideas, distractibility and increased goal-directed activities had high factor loadings (0.70-0.93) with moderate rates of endorsement, thus providing good discrimination between individuals with and without mania. The symptom assessing grandiosity performed less well in both samples. The quantitative mania factor scor...
Dimensions of self-rated mood in depressed, manic, and normal subjects
Comprehensive Psychiatry, 2001
Self-rated scales allow the comparison of subjective mood across the spectrum of manic, depressive, and euthymic states. This study examined the self-reported mood of manic, depressed, and normal subjects using a 23-item research instrument based on the Carroll-Klein model of bipolar disorder. The Multiple Visual Analog Scale (MVAS) measures the following dimensions: consummatory reward (seven items), incentive reward (two items), psychomotor speed (seven items), and central pain (seven items). The MVAS was completed by 31 manic inpatients, 43 depressed inpatients, and 29 normal volunteer subjects. Total scores, average item scores, and total dimension scores were obtained. Subjects also completed a global mood VAS and the Carroll Depression Scale (CDS). Groups were compared by analysis of variance (ANOVA) and post hoc Bonferroni-Dunn methods. In a separate post hoc analysis, the group of manic patients was divided at the median CDS score into "pure" and "dysphoric" manic subgroups. We found excellent congruence of average 23-item total MVAS scores with global VAS and CDS scores. Dimension scores on the MVAS conformed to the predictions of the Carroll-Klein model. Depressed patients differed significantly from both manic and normal subjects on each dimension. MVAS dimension scores of normal subjects did not differ significantly from those of manic patients. On the dimension of central pain, normal subjects had significantly less inhibited scores than the "pure" subgroup of manics. The results confirmed that the dimensions of the Carroll-Klein model are bipolar and orthogonal. By the MVAS technique, the self-reported mood of normal subjects is similar to the self-reported mood of manic patients on all dimensions of the Carroll-Klein model of bipolar disorder. The positive scores of both groups are clearly distinguished from the negative scores of depressed patients. Average MVAS scores of normal subjects approximated the conventional zero score only on the dimension of central pain. Normal subjects exhibit megalothymic (hyperthymia) on most dimensions of subjective mood. The negative MVAS scores of depressed patients are even more deviant from normal than the conventional scoring system would suggest.
International Journal of Methods in Psychiatric Research, 2009
The clinician-rated, 16-item Quick Inventory of Depressive Symptomatology (QIDS-C 16 ) has been extensively evaluated in patients with major depressive disorder (MDD). This report assesses the psychometric properties of the QIDS-C 16 in outpatients with bipolar disorder (BD, N = 405) and MDD (N = 547) and in bipolar patients in the depressed phase only (BD-D) (N = 99) enrolled in the Texas Medication Algorithm Project (TMAP) using classical test theory (CTT) and the Samejima graded item response theory (IRT) model.
An investigation of the self-report manic inventory as a diagnostic and severity scale for mania
Comprehensive Psychiatry, 1996
The initial study on the Self-Report Manic Inventory (SRMI} reported that it reliably diagnosed mania. In the current study, we replicated the initial study on the SRMI. We also evaluated its ability to quantify manic symptomatology and to measure change during inpatient treatment. The findings show that manic patients are capable of reporting their symptoms, regardless of their insight into their condition. They also confirm that the SRMI is a reliable diagnostic instrument and that it performs consistently over time when used with a 1-week time format. The SRMI is also sensitive to clinical improvement in hospitalized patients undergoing treatment. The SRMI correlated well with the Young Mania-Rating Scale (YMRS), which served as an external validator of SRMI scores at the beginning and end of hospitalization. Factor analysis produced two groups of manic subjects who closely resemble the hedonistic euphoric type and the energized dysphoric type initially reported by Shugar et al.
Journal of Affective Disorders, 2007
Background: Studies addressing self-reported quality of life (QoL) in acute mania are scarce and inconsistent. While it has been suggested that there is some disagreement between objective measures and subjective QoL as reported by acutely manic patients, this issue has not been systematically studied. This study aims to investigate the self-reported QoL in manic, depressed, and euthymic BD subjects, as compared to matched healthy controls. Methods: One-hundred and twenty type-I bipolar patients (40 manic, 40 depressed, and 40 euthymic) and 40 matched controls were studied. Self-reported QoL was assessed using the World Health Organization's Quality of Life Instrument-Short Version (WHOQOL-BREF). Objective functioning was assessed using the Global Assessment of Functioning (GAF), and depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items (HDRS) and the Young Mania Rating Scale (YMRS), respectively. Results: Manic patients presented the lowest GAF measures but reported same overall QoL as euthymic patients and controls, and better QoL than depressed patients. Within the manic subgroup, there was a significant inverse correlation between psychological QoL and GAF scores (r = − 0.54; p = 0.001). Limitations: The cross-sectional design and the lack of control for potential comorbid conditions are the major limitations of the present study. Conclusions: Our findings suggest that this mismatch between objective and subjective measures during acute mania may be associated with a lack of insight or awareness of their own illness.