Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales

Elizabeth D Ballard; Julia S Yarrington; Cristan A Farmer; Marc S Lener; Bashkim Kadriu; Níall Lally; Deonte Williams; Rodrigo Machado-Vieira; Mark J Niciu; Lawrence Park; Carlos A Zarate

doi:10.1016/j.jad.2018.01.027

Back

Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales

Journal article

Peer reviewed

Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales

Elizabeth D Ballard, Julia S Yarrington, Cristan A Farmer, Marc S Lener, Bashkim Kadriu, Níall Lally, Deonte Williams, Rodrigo Machado-Vieira, Mark J Niciu, Lawrence Park, …

Journal of affective disorders, Vol.231, pp.51-57

04/15/2018

DOI: 10.1016/j.jad.2018.01.027

PMCID: PMC5852677

PMID: 29448238

View Online

Abstract

Due to the heterogeneity of depressive symptoms—which can include depressed mood, anhedonia, negative cognitive biases, and altered activity levels—researchers often use a combination of depression rating scales to assess symptoms. This study sought to identify unidimensional constructs measured across rating scales for depression and to evaluate these constructs across clinical trials of a rapid-acting antidepressant (ketamine). Exploratory factor analysis (EFA) was conducted on baseline ratings from the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Snaith-Hamilton Pleasure Rating Scale (SHAPS). Inpatients with major depressive disorder (n = 76) or bipolar depression (n = 43) were participating in clinical ketamine trials. The trajectories of the resulting unidimensional scores were evaluated in 41 subjects with bipolar depression who participated in clinical ketamine trials. The best solution, which exhibited excellent fit to the data, comprised eight factors: Depressed Mood, Tension, Negative Cognition, Impaired Sleep, Suicidal Thoughts, Reduced Appetite, Anhedonia, and Amotivation. Various response patterns were observed across the clinical trial data, both in treatment effect (ketamine versus placebo) and in degree of placebo response, suggesting that use of these unidimensional constructs may reveal patterns not observed with traditional scoring of individual instruments. Limitations include: 1) small sample (and related inability to confirm measurement invariance); 2) absence of an independent sample for confirmation of factor structure; and 3) the treatment-resistant nature of the population, which may limit generalizability. The empirical identification of unidimensional constructs creates more refined scores that may elucidate the connection between specific symptoms and underlying pathophysiology. •Depression is a heterogeneous disorder with a variety of presenting symptoms.•Depression rating scales may capture a number of constructs.•This factor analysis studied rating scales often used in depression clinical trials.•The identified constructs showed differential responses to ketamine.•The constructs may help investigate the neurobiology of depression.

Clinical trials

Depression

Psychometrics

Ketamine

Factor analysis

Details

Title: Subtitle: Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales
Creators: Elizabeth D Ballard - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Julia S Yarrington - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Cristan A Farmer - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Marc S Lener - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Bashkim Kadriu - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Níall Lally - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Deonte Williams - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Rodrigo Machado-Vieira - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Mark J Niciu - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Lawrence Park - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Carlos A Zarate - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
Resource Type: Journal article
Publication Details: Journal of affective disorders, Vol.231, pp.51-57
DOI: 10.1016/j.jad.2018.01.027
PMID: 29448238
PMCID: PMC5852677
NLM abbreviation: J Affect Disord
ISSN: 0165-0327
eISSN: 1573-2517
Publisher: Elsevier B.V
Grant note: name: IRP-NIMH-NIH, award: NCT00088699, ZIA-MH002927, 04-M-0222
Language: English
Date published: 04/15/2018
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003947702771

Metrics

19 Record Views

64 Times Cited - Web of Science

See more details