The sufficiency of the HAM-D₆ as an outcome instrument in the acute therapy of antidepressants in the outpatient setting

Abstract

Objective. To re-analyse the Spanish outpatient study on the various versions of the Hamilton Depression Scale (HAM-D) by using item-response theory models for measuring unidimensionality. Methods. The Mokken analysis, based on the coefficient of homogeneity, was used. A coefficient of 0.40 or higher was accepted for unidimensionality. The three HAM-D versions were compared: HAM-D₆ (core items of depression), HAM-D₁₇ and HAM-D₂₁. Results. In total, 113 of the 116 patients included in the study completed the planned treatment period of 6 weeks. As the Mokken analysis depends as much on the sample of patients under examination (dispersion of scores on the item) as on the scale itself, the endpoint was used. For HAM-D₆, but not for HAM-D₁₇ or HAM-D₂₁, the coefficient of homogeneity was acceptable (0.44). Conclusion. The HAM-D₆ is a valid version of the Hamilton Scale to be recommended for monitoring depressed patients in antidepressant therapy in the outpatient setting.

• Hamilton Depression Rating Scale-6 (HAM-D6)
• psychometric properties
• acute treatment
• outcomes
• depression
• outpatients

Notes

^*Although an abstract of the article in [4] is already indexed in English, the paper was originally written entirely in Spanish. Please see Appendix 1 for a briefing of relevant information concerning patients and methods in this study. More in-depth details are fully available upon request to the corresponding author.