Rating depression severity in the elderly physically ill patient:Reliability and factor structure of the Hamilton and the Montgomery-Asberg Depression Rating Scales
M.F. Hammond
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 257- 261
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| Opplysninger | Objectives. To assess the appropriateness of the Hamilton DepressionRating Scale and the Montgomery-Asberg Depression Rating Scale indepressed elderly physically ill patients.Design. Depression scale scores from depressed medical inpatientswere assessed for internal consistency using Cronbach's ct, andsubjected to exploratory principal components factor analyses.Subjects. 100 medical inpatients, aged 65 years and over (median age80.5 years, range 66-99), 74 female, with Geriatric Mental StateSchedule-AGECAT case level diagnoses of depression.Materials. The 17-item Hamilton Depression Rating Scale (HDS) and theMontgomery-Asberg Depression Rating Scale (MADRS).Results. Coefficient alpha for the HDS was 0.46; for the MADRS 0.61.Successive deletion of HDS items to maximize alpha resulted in a six-item scale (alpha = 0.60); after deletion of five MADRS items, alphawas 0.77. Factor analysis of the HDS yielded a four-factor solutionaccounting for 57% of the variance, the majority due to anxiety andinsomnia items; the MADRS yielded a two-factor solution explaining60% of the variance.Conclusions. Coefficient alpha for both scales is well below theminimum necessary for the total score to be used to represent asingle construct. The HDS appears to be an unreliable measure ofdepression severity in elderly people with physical illness, as themajor variance in the scores is due to anxiety and insomnia. TheMADRS performs better, and with modification may be an appropriatemeasurement of depression severity in this population. (C) 1998 JohnWiley & Sons, Ltd.
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