1. ¹Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
2. ²Academic Computing Services, University of Texas Southwestern Medical Center, Dallas, TX, USA
3. ³Department of Psychiatry, Cornell University Medical College, New York, NY, USA
4. ⁴Department of Psychiatry New York State Psychiatric Institute, New York, NY, USA
5. ⁵Department of Psychiatry, Brown University and Rhode Island Hospital, Providence, RI, USA
6. ⁶Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
7. ⁷Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
8. ⁸Department of Psychology, State University of New York at Stony Brook, USA
9. ⁹Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
10. ¹⁰Department of Psychiatry, University of Arizona Health Sciences Center, Tucson, AZ, USA
11. ¹¹Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
12. ¹²Department of Psychiatry, Rush-St Luke's-Presbyterian Medical Center, Chicago, IL, USA
13. ¹³Department of Psychiatry, Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
14. ¹⁴Department of Psychiatry & Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
15. ¹⁵Bristol-Myers Squibb, Plainsboro, NJ, Atlanta, GA, USA
16. ¹⁶Department of Psychiatry & Human Behavior, Brown University and Butler Hospital, Providence, RI, USA

Correspondence: Dr AJ Rush, Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9086, USA. Tel: 214 648 4601; Fax: 214 648 4612; E-mail: john.rush@utsouthwestern.edu

Received 17 June 2004; Revised 16 September 2004; Accepted 28 September 2004; Published online 1 December 2004.

Abstract

This study evaluated and compared the performance of three self-report measures: (1) 30-item Inventory of Depressive Symptomatology-Self-Report (IDS-SR₃₀); (2) 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR₁₆); and (3) Patient Global Impression-Improvement (PGI-I) in assessing clinical outcomes in depressed patients during a 12-week, acute phase, randomized, controlled trial comparing nefazodone, cognitive-behavioral analysis system of psychotherapy (CBASP), and the combination in the treatment of chronic depression. The IDS-SR₃₀, QIDS-SR₁₆, PGI-I, and the 24-item Hamilton Depression Rating Scale (HDRS₂₄) ratings were collected at baseline and at weeks 1–4, 6, 8, 10, and 12. Response was defined a priori as a 50% reduction in baseline total score for the IDS-SR₃₀ or for the QIDS-SR₁₆ or as a PGI-I score of 1 or 2 at exit. Overall response rates (LOCF) to nefazodone were 41% (IDS-SR₃₀), 45% (QIDS-SR₁₆), 53% (PCI-I), and 47% (HDRS₁₇). For CBASP, response rates were 41% (IDS-SR₃₀), 45% (QIDS-SR₁₆), 48% (PGI-I), and 46% (HDRS₁₇). For the combination, response rates were 68% (IDS-SR₃₀ and QIDS-SR₁₆), 73% (PGI-I), and 76% (HDRS₁₇). Similarly, remission rates were comparable for nefazodone (IDS-SR₃₀=32%, QIDS-SR₁₆=28%, PGI-I=22%, HDRS₁₇=30%), for CBASP (IDS-SR₃₀=32%, QIDS-SR₁₆=30%, PGI-I=21%, HDRS₁₇=32%), and for the combination (IDS-SR₃₀=52%, QIDS-SR₁₆=50%, PGI-I=25%, HDRS₁₇=49%). Both the IDS-SR₃₀ and QIDS-SR₁₆ closely mirrored and confirmed findings based on the HDRS₂₄. These findings raise the possibility that these two self-reports could provide cost- and time-efficient substitutes for clinician ratings in treatment trials of outpatients with nonpsychotic MDD without cognitive impairment. Global patient ratings such as the PGI-I, as opposed to specific item-based ratings, provide less valid findings.