Structured Clinical Interview for DSM-IV Axis I Disorders – Clinician Version (SCID-CV) (for initial diagnosis); HamiltonRatingScale for Depression (HRSD); 30 Item Inventory of Depressive Symptomatology – Self Report (IDS-SR); and General Activities Form of the Quality of Life Enjoyment and Satisfaction Scale (Q-LES-Q general).
Patients and Methods: In a patient-assessor-blind, randomized and sham controlled trial, 90 depression patients with insomnia were assigned into three different groups, receiving EA in the treatment group, super ﬁ cial acupuncture at sham points in the control group A, or Streitberger non-insertion sham acupuncture in the control group B. Treatment was applied 3 times weekly for 8 consecutive weeks. The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were sleep parameters including sleep ef ﬁ ciency (SE), total sleep time (TST) and numbers of sleep awakenings (SA) recorded in the actigraphy, as well as applying the HamiltonRatingScale for Depression (HAMD-17), Self-RatingDepressionScale (SDS) and HamiltonRatingScale for Anxiety (HAMA). Assessments were performed at the baseline (week 0), week 4, week 8, and week 12. Linear mixed-effects models were used for analyses and all statistical tests were two-sided.
AD: Antidepressant; ADHD: Attention Deficit-Hyperactivity disorder; ANOVA: Analysis of variance; BP: Bipolar disorder; BP-I: Bipolar Type I disorder; BP-II: Bipolar Type II disorder; CGI-S: Clinical Global Impression-Severity of Illness; DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Text revision; GAF: Global assessment of functioning score; HAM-D17: Hamilton-RatingScale for Depression; MADRS: Montgomery – Asberg DepressionRatingScale; MDC: Mood Disorders Clinic; MDD: Major depressive disorder; MDE: Major depressive episode; MS: Mood stabilizers; MSM: Maudsley Staging Method; MUHC: McGill University Health Center; QIDS-C16: Quick Inventory of Depressive Symptomatology; SCID: Structured Clinical Interview for Diagnosis; SD: Standard deviation; SEM: Standard error of the mean; SGA: Second-generation antipsychotics; STAR*D: Sequenced Treatment Alternatives to Relieve Depression; TRD-UP: Treatment-Resistant Unipolar Depression; YMRS: Young Mania RatingScale
Methods: To compare the severity and burden of illness of patients with bipolar II versus bipolar I disorder, baseline demographic, clinical, and quality of life data were examined in 1900 patients with bipolar I and 973 patients with bipolar II depression, who were enrolled in five similarly designed clinical placebo-controlled trials of quetiapine immediate-release and quetiapine extended-release. Acute (8 weeks) response to treatment was also compared by assessing ratingscale scores, including Montgomery–Åsberg depressionratingscale, Hamiltonratingscale for anxiety, Young mania ratingscale, and clinical global impression-severity scores, in the bipolar I and II populations in the same pooled database.
BAI: Beck anxiety inventory; CAU: Care as usual; HADS-A: Hospital Anxiety and DepressionScale – Anxiety subscale; HAM-D: HamiltonDepressionRatingScale; IMR: Illness Management and Recovery; ITT: Intention-to-treat; LMM: Linear mixed model analysis; MINI interview: Mini-International Neuropsychiatric Interview; NEL: Netherlands Empowerment List; NEMESIS- 2: Netherlands Mental Health Survey and Incidence Study-2; PHQ-9: Patient Health Questionnaire; REML: Residual maximum likelihood; WHOQOL- BREF: World Health Organization quality of life instrument brief version; WRAP: Wellness Recovery Action Planning; ZemCAD (English SemCAD): Self- management for Chronic Anxiety and Depression
The initial onset of MDD occurs most frequently be- tween the ages of 15 years and 29 years, and recent stud- ies have found that approximately 50% of teenagers who are diagnosed with MDD experience a second episode by the age of 25 years [4,5]. One particularly problematic aspect of MDD is the increased likelihood for recurrence following each successive episode  with an ultimate mean of approximately 5 years between episodes . Furthermore, MDD is associated with an increased risk of medical disorders, including cardiovascular and endo- crine diseases [8-10]. In sum, MDD frequently begins during the teenage and early adult years, and it con- tinues over the life span causing substantial negative so- cial, economic, and health effects . The past few decades have witnessed the development and evaluation of new antidepressant medications and psychotherapies for MDD [12,13]. Despite these advances, depression treatment continues to be hampered by two major lim- itations: an unacceptably low rate of symptomatic remis- sion, and the virtual absence of any practical predictors of treatment response, whether partial or complete. Al- though it is widely considered that current interventions benefit approximately 60% of MDD patients, only about 30% to 40% of patients show full remission of their symptoms as defined by the MacArthur criteria (for ex- ample, a 17-item HamiltonDepressionRatingScale (HDRS) score <8) [14,15]. Approximately 30% more
Methods: One hundred fifty PD patients were enrolled from the Parkinson`s disease and Movement Disorders Center in Department of Neurology, Shanghai General Hospital from January 2013 to August 2014. This study examined PD patients with or without RBD as determined by the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), assessed motor subtype by Unified PD RatingScale (UPDRS) III at “ on ” state, and compared the sub-scale scores representing tremor, rigidity, appendicular and axial. Investigators also assessed the Hamilton Anxiety Scale (HAMA), HamiltonDepressionScale (HAMD), Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Parkinson ’ s disease Sleep Scale (PDSS).
scores. Therefore, complementary performance of both instruments may be useful . State anxiety was meas- ured using the Hamilton Anxiety RatingScale, HAMA . Furthermore, the Personal and Social Performance Scale, PSP, an interviewer-rating instrument, was used to assess four features of social functioning (socially useful activities; personal and social relationships; self-care; and disturbing and aggressive behavior) over a one-month period [12, 11]. These scales were applied for screening and baseline ratings and for the follow-up assessments at 3–9 weeks after baseline. A physician and a psychologist from our work group carried out the assessments. The software package Ergo-Assess ™  was used to assess functioning in activities of daily living (ADL) in the six domains of the International Classification of Func- tioning, Disability and Health, ICF : (1) activities of physical self-care, (2) activities of independent living, (3) neuropsychological functioning, (4) psychosocial func- tioning, (5) sensomotoric functions, and (6) basic work activities. In contrast to the other instruments, Ergo- Assess was used at 1–6 weeks, as opposed to 3–6 weeks, after baseline by a professional occupational therapist.
Background: Ratingscale items in a 6-week clinical trial of olanzapine versus placebo augmentation in patients with mixed bipolar disorder partially nonresponsive to ≥14 days of divalproex monotherapy were analyzed to characterize symptom patterns that could predict remission. At baseline, the two treatment groups were similar. Findings: Factor analysis with Varimax rotation was performed post hoc on baseline items of the 21-Item HamiltonDepressionRatingScale (HDRS-21) and Young Mania RatingScale (YMRS). Backwards-elimination logistic regression ascertained factors predictive of protocol-defined endpoint remission (HDRS-21 score ≤ 8 and YMRS score ≤ 12) with subsequent determination of optimally predictive factor score cutoffs.
depressants, pregnancy were excluded. Any drugs or illness which may modify CRP levels were excluded. After complete description of the study to the subjects, written informed consent was obtained from all participants. A detailed physical examination was done to rule out major medical or neurological illness. After that clinical assessment of patient group was done using HamiltonDepressionRatingScale (HAM-D), Beck Scale for Suicidal Ideation (BSSI), Suicide Behaviour Questionnaire (SBQ-R). 13-15 Blood samples of all groups
and somatic patterns of distress) and professional evaluation o f the same. One might argue that the HamiltonDepressionRatingScale instrument is not a diagnostic instrument but one that assesses symptom severity through an objective (clinical) lens. Perhaps future studies incorporating the use of Research Diagnostic instruments such as the SCAN and the SCID instead or in addition to the HDRS might clarify this incongruency. However, if the full configuration of common symptoms of depression (such as anxiety and somatic complaints) is not accurately represented within instruments that assess illness severity, they preclude examining the significance of such symptoms and raise questions over the construct validity of HamiltonDepressionRatingScale. For example, how central are symptoms of anxiety and somatic nature for an illness such as Neurotic Depression? Current diagnostic criteria for Depression preclude anxiety and somatic symptoms as core features of the disorder. It could be argued that Anxiety and Depression are not distinct nosological entities as symptoms of both conditions overlap. Although debated by nosologists (Hamilton 1960, Snaith 1993), both conditions. Anxiety and Depression, continue to merit separate categorical codes in current diagnostic manuals (lCD-10 and DSM-IV). Indeed, the abandonment of the term Melancholia and the adoption of the term Depression were in order, it was hoped, to “designate in an unassuming way exactly what was meant” (Meyer 1905 quoted in Snaith 1993).
Our standard assessment includes pre- and post-treatment HAMD-6, VAS-6 and Clinical Global Impression for Severity (CGI-S) (Guy, 1976). The 6-item HamiltonDepressionRatingScale (HAMD-6) (O’Sullivan et al., 1997) is superior to the HAMD-17 in terms of transferability, scalability and respon- siveness (Hooper and Bakish, 2000; Timmerby et al., 2017) and is unidimen- sional (Kieslich da Silva et al., 2018). It has been successfully applied in MDD, bipolar depression and depression with mixed features. It is described as “reliable, valid and sensitive to change” and “a clinically useful measure” (Lee et al., 2017). The CGI-S is an assessment of the severity of symptoms of mental disorders, made by a trained clinician on the basis of clinical experience in psychiatry (Busner and Targum, 2007; Guy, 1976). Ratings are from 1 (Normal, not at all ill) through to 7 (Among the most extremely ill patients). It is reliable and widely used (Pinna et al., 2015). The VAS-6 corresponds to the items from the HAMD-6 (May and Pridmore, 2019). For this study we also administered pre- and post-treatment a VAS – a 10 cm line with the anchor points: “Most tired possible” and “Not at all tired”, which was termed ‘VAS-tiredness’.
Adult patients suffering from depressive symptoms and referred from their PCP were potential candidates for the trial. Patients aged 18 years or older were eligible if they met criteria for a MD Episode, had a score ≥13 on HamiltonDepressionRatingScale (HDRS, 21-item ver- sion) , and were at their first or second MD Episode treated with antidepressants or psychotherapy. Patients who met all inclusion/exclusion criteria but had a HDRS score < 13 were reassessed after 1 month (watch- ful waiting arm); if their HDRS score was ≥ 13 after 1 month they were enrolled and randomised to IPC or SSRI. Inclusion and exclusion criteria are shown in Table 1.
measures were either designed for use with people with BD (EWS checklists and BIPQ), or have been successfully used with this population (MARS). They are all self-report, have high face validity, and have been shown to be valid and reliable measures, making them highly applicable to Web-based use. Interviewer-rated outcome measures were administered by telephone by two trained research assistants, at baseline, 12-, 24-, 36-, and 48-week follow-up. These included SCID-LIFE  providing a retrospective weekly rating of depression (1-6) and mania (1-6) (scores of 5 or 6 indicate major mood episode); HamiltonDepressionRatingScale (HAM-D scores above 7 indicate mild depression, above 13 moderate, and above 18 severe) , and Mania RatingScale (MRS scores of 11 and above indicate hypomania) ; the Personal and Social Performance Scale (PSP scores 70-80 indicate mild difficulties, above 80 is good functioning) ; and the Multidimensional Scale of Independent Functioning (MSIF Likert scale 1=normal functioning, to 7=total disability) . Self-report outcome measures were collected at baseline, 24, and 48 weeks and included the Work and Social Adjustment Scale (WSAS less than 10=subclinical; 10-20 some functional impairment; above 20 moderate psychopathology) ; Quality of Life in Bipolar Disorder (QoLBD range 48-240 with high score=higher quality of life) ; and the Bipolar Recovery Questionnaire (BRQ score 0-3600, high score=higher recovery) . Web-based versions of the EQ5D5L  and the Client Service Receipt Inventory (CSRI)  were piloted to assess the feasibility of collecting this data on the Web and to test the sensitivity to change in this population as neither have been previously used in this format. A checklist to record current treatment was developed for the study to define usual treatment.
The clinician-rated measurements used included the Clinical Global Impression – Severity scale (CGI-S), a seven-point scale that requires clinicians to rate the severity of the condi- tion being assessed (ranging from 1 [normal/not at all], to 7 [extremely ill]). The severity of depression was assessed using: i) the 17-item HamiltonDepressionRatingScale (HAMD-17), a clinician-rated scale; ii) the Thai Depression Inventory, a 20-item, four-ratingscale which assesses the severity of depressive symptoms among respondents, rang- ing from 1 (most severe) to 4 (normal); iii) the Thai GDS, a 30-item, true–false questionnaire used to assess depressive symptoms in participants aged 60 years of age or over; 13
Twenty – five consecutive depressed male patients who met the inclusion criteria were evaluated for sleep quality and erectile dysfunction. The diagnoses of depressive episode and recurrent depressive disorder were made using the criteria from the 10 th edition of the International Classification of Diseases (ICD - 10) by the World Health Organization (WHO). The severity of the depression was rated using the 17 – item HamiltonDepressionRatingScale (HamD). The sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) while erectile dysfunction was assessed using The International Index of Erectile Function (IIEF-5) Questionnaire.
Methods: A total of 115 patients diagnosed with major depressive disorder (MDD) and bipolar disorder (in a major depressive episode), who underwent overnight polysomnogra- phy, were studied retrospectively. They were divided into two groups: non-OSA and OSA. The patients who had apnea–hypopnea index (AHI) ,5 were defined as the non-OSA group, whereas the OSA group was defined as those with an AHI $5. Logistic regression was used to analyze the association among AHI and clinical factors, including sex, age, body mass index (BMI), HamiltonDepressionRatingScale (HAMD), Hamilton Anxiety RatingScale, Pittsburgh Sleep Quality Index (PSQI), and diagnosis (MDD or bipolar disorder [in a major depressive episode]).
All participants were assessed using the K-BDRS and then interviewed with the Montgomery and Asberg De- pression Scale (MADRS, ), the 17-item HamiltonDepressionScale (HAMD, ), and the Young Mania RatingScale (YMRS, ). These measures were se- lected to assess the concurrent validity of the K-BDRS. All investigators and raters involved in this study were clinical psychiatrists with more than 10 years of clinical experience in bipolar disorder, and had received formal training in the use of all the rating scales.