Rasch analysis of HDRS-17.

Rasch analysis of HAM-D6.

Multiple linear regression analyses of Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores.

BackgroundIt has been claimed that efficacy estimates based on the Hamilton Depression Rating-Scale (HDRS) underestimate antidepressants true treatment effects due to the instrument’s poor psychometric properties. The aim of this study is to compare efficacy estimates based on the HDRS with the gold standard procedure, the Montgomery-Asberg Depression Rating-Scale (MADRS).Methods and findingsWe conducted a meta-analysis based on the comprehensive dataset of acute antidepressant trials provided by Cipriani et al. We included all placebo-controlled trials that reported continuous outcomes based on either the HDRS 17-item version or the MADRS. We computed standardised mean difference effect size estimates and raw score drug-placebo differences to evaluate thresholds for clinician-rated minimal improvements (clinical significance). We selected 109 trials (n = 32,399) that assessed the HDRS-17 and 28 trials (n = 11,705) that assessed the MADRS. The summary estimate (effect size) for the HDRS-17 was 0.27 (0.23 to 0.30) compared to 0.30 (0.22 to 0.38) for the MADRS. The effect size difference between HDRS-17 and MADRS was thus only 0.03 and not statistically significant according to both subgroup analysis (p = 0.47) and meta-regression (p = 0.44). Drug-placebo raw score difference was 2.07 (1.76 to 2.37) points on the HDRS-17 (threshold for minimal improvement: 7 points according to clinician-rating and 4 points according to patient-rating) and 2.99 (2.24 to 3.74) points on the MADRS (threshold for minimal improvement: 8 points according to clinician-rating and 5 points according to patient-rating).ConclusionsOverall there was no meaningful difference between the HDRS-17 and the MADRS. These findings suggest that previous meta-analyses that were mostly based on the HDRS did not underestimate the drugs’ true treatment effect as assessed with MADRS, the preferred outcome rating scale. Moreover, the drug-placebo differences in raw scores suggest that treatment effects are indeed marginally small and with questionable importance for the average patient.

To estimate the extent to which physical capability, depressive symptoms, balanced self-efficacy (BSE), and other risk factors, that are interrelated with stroke, influence the quality of life (QoL) in stroke survivors. A theoretical model based on Wilson and Cleary’s model tested the specific hypotheses: 1) physical capability has an indirect effect on QoL mediated by BSE; 2) physical capability has an indirect effect on QoL by depressive symptoms; 3) stroke risk factors (hypertension/diabetes/gender) moderate the above relationship. Six hundred and seventy stroke survivors were enrolled from ten different hospitals in Yunnan province from 2019 to 2021. Patients’ mental and physical function was assessed using the Brunnstrom recovery stage (BRS), mini-balance evaluation system test (Mini-BEST), Barthel index (BI), Activities-specific Balance Confidence scale (ABC), and Hamilton depression scale (HAM-D). The structural equation model (SEM) was used to test the moderated mediation model in Mplus 8.0 software. The model showed a good fit (RMSEA =  0.075, SRMR =  0.010). BSE significantly mediated the relationship between physical capability and QoL (β =  0.322, p =  0.002). Hypertension was found a significant moderator of all the direct paths from physical capability to QoL through depressive symptoms (В =  0.412, p =  0.015; В =  0.831, p =  0.020, respectively). This study provides a better insight into the relationship between physical capability and QoL via BSE in stroke survivors, which may help establish appropriate treatment for these individuals.

Relationship between HAMD score and TSH levels in Graves’ disease patients after 131I treatment.

Introduction: Post-stroke depression (PSD) is a common mental health problem after cerebrovascular accidents. There are several treatments that have been shown to be effective in treating post-stroke depression. However, it is not clear which treatment is more effective.Methods: In this meta-analysis, an appropriate search strategy was used to search eligible randomized controlled trials (RCTs) on different treatments to treat patients with Post-stroke depression published up to December 2021 from the CNKI, PubMed, and Cochrane Library. We assessed the mean difference or odds ratio between each treatment and placebo and summarized them as the average and 95% confidence interval (CI) by conducting Bayesian network meta-analyses.Results: By constructing a Bayesian network meta-analysis, we found that acupuncture combined with fluoxetine (vs placebo MD, −8.9; 95% CI, [−15, −2.9]) or paroxetine (vs placebo MD,—8.5; 95% CI, [−15, −2.5]) was the most effective for change in Hamilton depression scale (HAMD) at the end of the 4th week. For change in Hamilton depression scale at the end of the 8th week, rTMS combined with paroxetine (vs placebo MD, −13; 95% CI, [−17, −7.9]) had the greatest amount of change. The efficacy of medication combined with adjuvant therapy was also superior for the percentage of patients with Hamilton depression scale change over 50%.Discussion: The combination of antidepressants with adjuvant therapy may enhance the efficacy of antidepressants and achieve better results than antidepressant monotherapy in both Hamilton depression scale changes at the end of week 4 or 8 and 50% Hamilton depression scale improvement rate. Acupuncture combined with fluoxetine treatment was more effective in the treatment of post-stroke depression at week 4, while rTMS combined with paroxetine was more effective at week 8. Further research is needed to determine whether acupuncture combined with fluoxetine is better than rTMS combined with paroxetine for post-stroke depression at week 8.

Spearman's rank correlation coefficients between branched-chain amino acids and Hamilton Depression Rating Scale (HAMD-17) and Beck Depression Inventory (BDI-II) scores.

Severity and improvement percentage of depression in patients according to categorical variables a,b.

S2 File - Mediation and moderation analysis of the association between physical capability and quality of life among stroke patients

Contingency table analysis of the correlation between TPOAb and HAMD score.

Independent variables predicting the severity and improvement percentage of depression at the two-year follow-up point a,b.

• Excluded for meta-analysis due to different items/cut-points;** Excluded for meta-analysis due to duplicate database; BDI: Beck Depression Inventory; CESD: Center for Epidemiologic Studies of Depression; HDI: Hamilton Depression Inventory; PDSS: Postpartum Depression Screening Scale; WMH-CIDI: World Mental Health Organization Composite International Diagnostic Interview; UM-CIDI: University of Michigan’s version of CIDI; PHQ: Patient Health Questionnaire; GDS: Geriatric Depression Scale; HSCL: Hopkins Symptom Checklist; MDD: Major Depressive Disorder; MDE: Major Depressive Episode; NLAAS: National Latino and Asian American Study; CPES: Collaborative Psychiatric Epidemiology Surveys, the CPES includes the National Comorbidity Survey-Replication, the NLAAS and the National Survey of American Life.Review of prevalence studies of depression in Asian-Americans.

Legend: HAM, 17-item Hamilton Depression Rating Scale; BDI, 21-item Beck Depression Inventory; CORE, Core Assessment of Psychomotor change. The items that did not enter the models by Uher and Parker are coded in the “none” item dimension category.Exploratory Factor Analysis six-factor solution.

Background: Repetitive transcranial magnetic stimulation (rTMS) has been proven to be safe and effective in treating major depressive disorder (MDD). However, the treatment parameters of rTMS are still divergent and need to be optimized further. The aim of this study was to compare the efficacy of rTMS in treating MDD with different parameters of stimulating frequency and location, and course of treatment.Methods: A total of 221 patients with MDD were recruited in the randomized, double-blind, controlled trial. All eligible patients were randomly assigned into four treatment groups: (1) 10 Hz in left dorsolateral pre-frontal cortex (DLPFC) (n = 55), (2) 5 Hz in left DLPFC (n = 53), (3) 10 Hz in bilateral DLPFC (n = 57), and (4) 5 Hz in bilateral DLPFC (n = 56). The patients received treatment for 6 weeks and an additional 6-week optional treatment. The efficacies were evaluated by Hamilton Depression Rating Scale-24 items (HDRS) and Clinical Global Impressions Scale (CGI). The trial is registered at the Chinese Clinical Trial Registry as ChiCTR-TRC-12002248.Results: The ANOVAs of HDRS scores up to 6 weeks and 12 weeks with repeated measure of time showed a significant effect of duration without statistical difference among four treatment groups and no significance when time was interacted with inter-group as well. The response rates up until the 5th week were significantly different with the previous week.Conclusions: It concludes that there were no statistical differences in the efficacy of rTMS between unilateral left and bilateral DLPFC, and between 5 and 10 Hz for treating MDD.

Clinical demographics of Graves’ disease patients.

Meta-analysis was not conducted due to duplicate dataset;*data from Kim & Lopez [78]; UM-CIDI: University of Michigan’s version of Composite International Diagnostic Interview; WHM-CIDI: World Mental Health Organization CIDI; HDI: Hamilton Depression Inventory; PHQ: Patient Health Questionnaire; PDSS: Postpartum Depression Screening Scale; HSCL: Hopkins Symptom Checklist; GDS: Geriatric Depression Scale; BDI: Beck Depression Inventory; CESD: Center for Epidemiologic Studies of Depression.Summary of depression prevalence by measurement type.

uOCD = unmedicated OCD, mOCD = medicated OCD, uHC = unmedicated healthy controls, mPC = medicated patient controls. Group differences in age, years of education, Hamilton Anxiety Scale score (HAM-A), and Hamilton Depression Scale score (HAM-D) were evaluated with separate 2×2 ANOVAs using diagnosis (OCD, controls) and medication (unmedicated, medicated) as between-subjects factors. Chi-square tests compared gender (all groups), while independent samples t-tests were used to compare mOCD and uOCD groups on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. sd = standard deviation, D = main effect of diagnosis factor, M = main effect of medication factor, D×M = interaction between diagnosis and medication. Only those effects significant at p

All reported depression outcomes were assessed at the end of the treatment period except MIND-IT [33] where depression outcomes were assessed 18 months post-myocardial infarction (0–9 months after completion of treatment).†Cardiovascular serious adverse events = myocardial infarction, congestive heart failure, worsening angina, stroke, or other cardiovascular events.‡Of the 2,481 randomized patients in the ENRICHD trial who met eligibility criteria for MDD, minor depression, or dysthymia and/or low social support [31], data are reported only for the subset of 955 randomized patients diagnosed with MDD. Original data for the ENRICHD trial were obtained from the National Heart Lung and Blood Institute.§In the depression outcome analyses presented, the last-observation-carried-forward approach was applied for missing data. The original published report of the ENRICHD trial [31] reported outcome data for completers. Based on completer data only, Δ HAMD-17: Hedges' g = 0.24, 95% CI 0.09 to 0.39 (N = 690, CBT: 348, UC: 342). Δ BDI: Hedges' g = 0.36, 95% CI 0.21 to 0.51 (N = 699, CBT: 357, UC: 342).∥The Honig, 2007 [32] study was an RCT nested within the MIND-IT study [33].¶Total cardiac events include cardiac death, recurrent myocardial infarction, revascularization, heart failure, myocardial ischemia, and ventricular arrhythmia. 17 patients were lost to follow-up (Tx, n = 196; UC, n = 118).#Patients were assessed with HAMD-17 at 16 weeks, but not 24 weeks.*Major adverse cardiac events = events involving death or requiring hospitalization.††Hazard ratio from Kaplan-Meier analysis, but number of deaths per group not provided for follow-up study (Glassman AH, Bigger JT,Jr, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: Seven-year follow-up of SADHART participants. Arch Gen Psychiatry. 2009 Sep;66:1022–9). BDI = Beck Depression Inventory; BDI-II = Beck Depression Inventory – II; CBT = cognitive behavior therapy; CM = clinical management; CGI-I = Clinical Global Impression-Improvement; CGI-S = Clinical Global Impression-Severity; CI = confidence interval; CREATE = Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy trial; ENRICHD = Enhancing Recovery in Coronary Heart Disease Patients; HAMD-17 = 17-item Hamilton Depression Rating Scale; HAMD-24 = 24-item Hamilton Depression Rating Scale; HAMD-31 = 31-item Hamilton Depression Rating Scale; IPT = interpersonal therapy; MADRS = Montgomery-Asberg Depression Rating Scale; MI = myocardial infarction; MIND-IT = Myocardial Infarction and Depression-Intervention trial; NA = not applicable; SADHART = Sertraline Antidepressant Heart Attack Randomized trial; SADHART-CHF = Sertraline Against Depression and Heart Disease in Chronic Heart Failure; SCL-90-D = depression subscale of the Symptom Checklist 90; Tx = treatment; UC = usual care.