Assessing anxious features in depressed outpatients

✍ Scribed by Shawn M. McClintock; Mustafa M. Husain; Ira H. Bernstein; Stephen R. Wisniewski; Madhukar H. Trivedi; David Morris; Jonathan Alpert; Diane Warden; James F. Luther; Susan G. Kornstein; Melanie M. Biggs; Maurizio Fava; A. John Rush

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 381 KB
• Volume: 20
• Category: Article
• ISSN: 1049-8931
• DOI: 10.1002/mpr.353

✦ Synopsis

Abstract

Both the 17‐item Hamilton Rating Scale for Depression (HRSD~17~) and 30‐item Inventory of Depressive Symptomatology – Clinician‐rated (IDS‐C~30~) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric properties of the two anxiety subscales (HRSD~ANX~ and IDS‐C~ANX~) in a large sample (N = 3453) of outpatients with non‐psychotic major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Approximately 48% of evaluable participants had at least one concurrent anxiety disorder by the self‐report Psychiatric Diagnostic Screening Questionnaire (PDSQ). The HRSD~ANX~ and IDS‐C~ANX~ were highly correlated (r = 0.75) and both had moderate internal consistency given their limited number of items (HRSD~ANX~ Cronbach's alpha = 0.48; IDS‐C~ANX~ Cronbach's alpha = 0.58). The optimal threshold for ascribing the presence/absence of anxious features was found at a total score of eight or nine for the HRSD~ANX~ and seven or eight for the IDS‐C~ANX~. It would seem beneficial to delete item 17 (loss of insight) from the HRSD~ANX~ as it negatively correlated with the scale's total score. Both the HRSD~ANX~ and IDS‐C~ANX~ subscales have acceptable psychometric properties and can be used to identify anxious features for clinical or research purposes. Copyright © 2011 John Wiley & Sons, Ltd.