On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales
Objective. Anxious major depressive disorder (A-MDD) is differentially diagnosed from nonanxious MDD (NA-MDD) as MDD with a cut-off score ≥7 on the HAM-D anxiety-somatization factor (ASF). We investigated whether additional HAM-D items discriminate A-MDD from NA-MDD. Moreover, we tested the validity...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/294516 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563788422840320 |
|---|---|
| author | George Konstantakopoulos Vasilios G. Masdrakis Manolis Markianos Panagiotis Oulis |
| author_facet | George Konstantakopoulos Vasilios G. Masdrakis Manolis Markianos Panagiotis Oulis |
| author_sort | George Konstantakopoulos |
| collection | DOAJ |
| description | Objective. Anxious major depressive disorder (A-MDD) is differentially diagnosed from nonanxious MDD (NA-MDD) as MDD with a cut-off score ≥7 on the HAM-D anxiety-somatization factor (ASF). We investigated whether additional HAM-D items discriminate A-MDD from NA-MDD. Moreover, we tested the validity of ASF criterion against HAM-A, gold standard of anxiety severity assessment. Methods. 164 consecutive female middle-aged inpatients, diagnosed as A-MDD () or NA-MDD () by the normative HAM-A score for moderate-to-severe anxiety (≥25), were compared regarding 17-item HAM-D scores. The validity of ASF ≥7 criterion was assessed by receiver-operating characteristics (ROC) analysis. Results. We found medium and large effect size differences between A-MDD and NA-MDD patients in only four out of the six ASF items, as well as in three further HAM-D items, namely, those of agitation, middle insomnia, and delayed insomnia. Furthermore, the ASF cut-off score ≥9 provided the optimal trade-off between sensitivity and specificity for the differential diagnosis between A-MDD and NA-MDD. Conclusion. Additional HAM-D items, beyond those of ASF, discriminate A-MDD from NA-MDD. The ASF ≥7 criterion inflates false positives. A cut-off point ≥9 provides the best trade-off between sensitivity and specificity of the ASF criterion, at least in female middle-aged inpatients. |
| format | Article |
| id | doaj-art-853c6a312df041e08ce1e05cfced8471 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-853c6a312df041e08ce1e05cfced84712025-02-03T01:12:38ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/294516294516On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton ScalesGeorge Konstantakopoulos0Vasilios G. Masdrakis1Manolis Markianos2Panagiotis Oulis3First Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, GreeceFirst Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, GreeceFirst Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, GreeceFirst Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, GreeceObjective. Anxious major depressive disorder (A-MDD) is differentially diagnosed from nonanxious MDD (NA-MDD) as MDD with a cut-off score ≥7 on the HAM-D anxiety-somatization factor (ASF). We investigated whether additional HAM-D items discriminate A-MDD from NA-MDD. Moreover, we tested the validity of ASF criterion against HAM-A, gold standard of anxiety severity assessment. Methods. 164 consecutive female middle-aged inpatients, diagnosed as A-MDD () or NA-MDD () by the normative HAM-A score for moderate-to-severe anxiety (≥25), were compared regarding 17-item HAM-D scores. The validity of ASF ≥7 criterion was assessed by receiver-operating characteristics (ROC) analysis. Results. We found medium and large effect size differences between A-MDD and NA-MDD patients in only four out of the six ASF items, as well as in three further HAM-D items, namely, those of agitation, middle insomnia, and delayed insomnia. Furthermore, the ASF cut-off score ≥9 provided the optimal trade-off between sensitivity and specificity for the differential diagnosis between A-MDD and NA-MDD. Conclusion. Additional HAM-D items, beyond those of ASF, discriminate A-MDD from NA-MDD. The ASF ≥7 criterion inflates false positives. A cut-off point ≥9 provides the best trade-off between sensitivity and specificity of the ASF criterion, at least in female middle-aged inpatients.http://dx.doi.org/10.1155/2013/294516 |
| spellingShingle | George Konstantakopoulos Vasilios G. Masdrakis Manolis Markianos Panagiotis Oulis On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales The Scientific World Journal |
| title | On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales |
| title_full | On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales |
| title_fullStr | On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales |
| title_full_unstemmed | On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales |
| title_short | On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales |
| title_sort | on the differential diagnosis of anxious from nonanxious major depression by means of the hamilton scales |
| url | http://dx.doi.org/10.1155/2013/294516 |
| work_keys_str_mv | AT georgekonstantakopoulos onthedifferentialdiagnosisofanxiousfromnonanxiousmajordepressionbymeansofthehamiltonscales AT vasiliosgmasdrakis onthedifferentialdiagnosisofanxiousfromnonanxiousmajordepressionbymeansofthehamiltonscales AT manolismarkianos onthedifferentialdiagnosisofanxiousfromnonanxiousmajordepressionbymeansofthehamiltonscales AT panagiotisoulis onthedifferentialdiagnosisofanxiousfromnonanxiousmajordepressionbymeansofthehamiltonscales |