PRESENT USE OF THE HAMILTON DEPRESSION RATING-SCALE - OBSERVATIONS ONMETHOD OF ASSESSMENT IN RESEARCH OF DEPRESSIVE-DISORDERS

Background. The Hamilton Depression Rating Scale retains its primacy i n research. There have been recent important critiques. It is clear th at instructions provided by its author are widely overlooked. Method. A survey of the present use of the HDRS was conducted by inspection of five major journals publishing studies in the field of psychiatry. No te was especially made of whether a recognised version of the Scale wa s quoted; also of whether authors had selected specific scores on one or other of the versions to indicate a criterion for inclusion of a su bject in a study, and likewise whether a specific score had been selec ted as an indication of recovery following some procedure or treatment . Results. One hundred and fourteen articles were reviewed in which 71 had used a depression scale. This was the HDRS in 66% of the studies. There was considerable evidence that the instruction that the HDRS wa s only to be used in situations where the patient had received a diagn osis of a primary depressive illness had been ignored. There was consi derable degree of arbitrary selection of Scale scores. Conclusions. Th e survey causes concern about the methodology of much research in the field of assessment of severity of psychiatric disorder. The rationale of assessment by the rating scale method is considered and suggestion made for improvement in research practice.