Measuring Depression at the End of Life: Is the Hamilton Depression Rating Scale a Valid Instrument?

Depression at the end of life is a common mental health issue with serious implications for quality of life and decision making. This study investigated the reliability and validity of one of the most frequently used measures of depression, the Hamilton Depression Rating Scale (HAM-D) in 422 patient...

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Bibliographic Details
Published in:Assessment (Odessa, Fla.) Fla.), 2009-03, Vol.16 (1), p.43-54
Main Authors: Olden, Megan, Rosenfeld, Barry, Pessin, Hayley, Breitbart, William
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Anxiety
Attitude to Death
Behavior Disorders
Cancer
Clinical Diagnosis
Correlation
Death
Decision Making
Depression (Psychology)
Depression - diagnosis
Emotional Response
Factor Analysis
Female
Hamilton Rating Scale for Depression
Hospitals
Humans
Male
Mental Disorders
Mental Health
Middle Aged
Models, Psychological
Neoplasms - psychology
Palliative Care - psychology
Patients
Psychological Patterns
Psychometrics
Psychomotor Skills
Quality of Life
Rating Scales
Reproducibility of Results
Risk Factors
ROC Curve
Sleep
Social Support
Suicide
Symptoms (Individual Disorders)
Terminal Care - psychology
Terminal Illness
Terminally Ill - psychology
Test Reliability
Test Validity
Validity
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Summary:Depression at the end of life is a common mental health issue with serious implications for quality of life and decision making. This study investigated the reliability and validity of one of the most frequently used measures of depression, the Hamilton Depression Rating Scale (HAM-D) in 422 patients with terminal cancer admitted to a palliative care hospital. The HAM-D demonstrated high reliability and concurrent validity with depression diagnosis, based on Structured Clinical Interview for DSM-IV Axis I Disorders, non-patient research version (SCID-I/NP Depression Module). Receiver Operating Characteristic (ROC) analyses generated an area under the curve of .91, indicating high sensitivity and specificity. The HAM-D strongly correlated with several measures of distress (e.g., hopelessness, desire for hastened death, and suicidal ideation). Factor analysis generated 4 factors (anxiety, depressed mood, insomnia, and somatic symptoms), accounting for 42% of the variance. Implications for assessing depression in this population are discussed.
ISSN:1073-1911
1552-3489
DOI:10.1177/1073191108320415