THE HAMILTON DEPRESSION SCALE - EVALUATION OF OBJECTIVITY USING LOGISTIC-MODELS

The consistency of the Hamilton Depression Scale (HDS) as a measure of the severity of depressive states was examined when the scale was used weekly during a trial with imipramine. By use of logistic models (Rasch), the consistency of the HDS was considered across patient-variables as age, sex, plasma levels of imipramine and diagnosis. The original 17-item HDS was without adequate consistency, i.e., the total score of the sample of items was no 1-dimensional measure of depressive states. A melancholia subscale of the HDS contained items the total of which can be used to compare patients quantitatively, although in some part of the analysis these items showed ceiling effect. The melancholia subscale (containing the items depressed mood, guilt, work and interests, retardation, psychia anxiety and general somatic symptoms) can form the basis for further improvements in the field of quantitative rating scales for depressive states.