Measuring Depression

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Science and medicine have languages all their own. Without a common way of expressing things communication would be inexact, the opposite of what is required in both research and treatment.

Measuring the depths of depression might, at first blush, seem unnecessary. Depression is bad - what more does anyone need to know? The answer is, a lot. By creating a system of measurement which physicians and other practitioners can agree on, treatment can be standardized. Optimal dosages of medication, treatment protocols, admissions to hospitals, insurance coverage - all are based on a determination of the severity of the disorder being treated.

Many Measurements to Choose From

There is no ultimate scale to determine the severity of depression. That is because there are so many scales to choose from, each with a slightly different focus. There are scales that are determined by the physician (Beck Depression Inventory, Major Depression Inventory), with answers to the questions coming from patient interviews.

There are also scales that are directly answered by the patient (The Patient Health Questionnaire, The Zung Self-Rating Depression Scale), and then turned in to the physician as an adjunct to the patient interview.

Researchers have their own scales, with answers gained from test subjects. One of the most used scales is the Hamilton Depression Rating Scale, which asks 21 questions, with between 3 and 5 possible answers per question. The other most used scale is the Montgomery-Asberg Depression Rating Scale, with ten items to be completed by researchers.

Some scales are for use only in subsets of patients, such as those suffering from post-partum depression (Edinburgh Postnatal Depression Scale, Postpartum Depression Screening Scale,) elderly patients (Geriatric Depression Scale, Cornell Scale for Depression in Dementia,)drug and alcohol abusers (Alcohol Use Disorders Identification Test)or those patients who exhibit suicidal ideations (Columbia-Suicide Severity Rating Scale.)

Why This Matters

For the individual who is suffering from depression, perhaps this doesn’t matter a great deal. For researchers, these measurements tell them whether they are on the right track when it comes to experimental treatments. Each scale defines the symptoms of depression and each scale can be used as a before-and-after measurement of the effectiveness of a particular treatment.

Physicians and other mental health practitioners might use these evaluations differently. Is the patient responding in the anticipated way to their medication? How much improvement has occurred over the period of treatment? Might we see better results with a different medication or a different therapeutic approach?

Everything in our world is measured or evaluated on an ongoing basis. It makes perfect sense that ways of measuring depression have been developed. Research and feedback are two aspects of this measurement that benefit all who suffer with depression.

Sources: Medscape , B.C. Medical Journal


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