scholarly journals Statistically Significant Antidepressant-Placebo Differences on Subjective Symptom-Rating Scales Do Not Prove That the Drugs Work: Effect Size and Method Bias Matter!

2018 ◽  
Vol 9 ◽  
Author(s):  
Michael P. Hengartner ◽  
Martin Plöderl
Keyword(s):  
Effect Size ◽  
Rating Scales ◽  
Subjective Symptom ◽  
Method Bias ◽  
Work Effect ◽  
Symptom Rating

Psychotic Symptom Rating Scales

1999 ◽  
Author(s):  
G. Haddock ◽  
J. McCarron ◽  
N. Tarrier ◽  
E. B. Faragher
Keyword(s):  
Psychotic Symptom ◽  
Rating Scales ◽  
Symptom Rating

Systematic review and meta-analysis of the placebo effect in panic disorder: Implications for research and clinical practice

2022 ◽  
pp. 000486742110687
Author(s):  
Masoud Ahmadzad-Asl ◽  
Farnoush Davoudi ◽  
Safoura Mohamadi ◽  
Fatemeh Hadi ◽  
Seyed Aria Nejadghaderi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Panic Disorder ◽  
Placebo Effect ◽  
Effect Size ◽  
Rating Scales ◽  
Data Extraction ◽  
Meta Analysis ◽  
Placebo Response ◽  
Patient Reports

Objective: This review aimed to measure the degree of placebo response in panic disorder. Data Sources: We searched major databases up to 31 January 2021, for randomized pharmacotherapy trials published in English. Study Selection: A total of 43 studies met inclusion criteria to be in the analysis (with 174 separate outcome measurements). Data Extraction: Changes in outcome measures from baseline in the placebo group were used to estimate modified Cohen’s d effect size. Results: A total of 43 trials (2392 subjects, 174 outcomes using 27 rating scales) were included in the meta-analysis. Overall placebo effect size was 0.57 (95% confidence interval = [0.50, 0.64]), heterogeneity ( I2: 96.3%). Higher placebo effect size was observed among clinician-rated scales compared to patient reports (0.75 vs 0.35) and among general symptom and anxiety scales compared to panic symptoms and depression scales (0.92 and 0.64 vs 0.56 and 0.54, respectively). There was an upward trend in effect size over the publication period ( r = 0.02, p = 0.002) that was only significant among clinician-rated scales ( r = 0.02, p = 0.011). There was no significant publication bias, Egger’s test ( p = 0.08). Conclusion: We observed a substantial placebo effect size in panic disorder. This effect was more prominent for some aspects of panic disorder psychopathology than for others and was correlated with the source of the assessment and publication year. This finding has implications both for research design, to address the heterogeneity and diversity in placebo responses, and for clinical practice to ensure optimal quality of care. Systematic review registration number: PROSPERO, CRD42019125979.

Clinical target syndromes in psychiatry: latent structure analysis versus factor analysis

1991 ◽  
Vol 6 (6) ◽  
pp. 301-306 ◽  
Author(s):  
P Bech
Keyword(s):  
Factor Analysis ◽  
Structure Analysis ◽  
Statistical Models ◽  
Rating Scales ◽  
Rating Scale ◽  
Latent Structure ◽  
Depression And Anxiety ◽  
Sufficient Statistics ◽  
Latent Structure Analysis ◽  
Symptom Rating

SummaryThe algorithms for the demonstration of shared phenomenology of psychiatric syndromes in DSM-III are resistant to quantification. In contrast, the rating scale approach quantifies clinical target syndromes in psychiatry. The two most useful statistical models for quantifying shared phenomenology by symptom rating scales have been reviewed; namely factor analysis and latent structure analysis. Results have shown that factor analysis has demonstrated dimensions of dementia, delirium, schizophrenia, mania, outward aggression, depression and anxiety. Latent structure analysis has confirmed that the items of brief rating scales (such as the Melancholia Scale) are additively related implying that their total scores are sufficient statistics for the measurement of these factors or dimensions. Latent structure analysis should be considered as a psychometric “glasnost” compared to algorithm-resistant logic of quantification in DSM-III.

scholarly journals Symptom Dimensions of the Psychotic Symptom Rating Scales in Psychosis: A Multisite Study

2014 ◽  
Vol 40 (Suppl_4) ◽  
pp. S265-S274 ◽  
Author(s):  
Todd S. Woodward ◽  
Kwanghee Jung ◽  
Heungsun Hwang ◽  
John Yin ◽  
Laura Taylor ◽  
...  
Keyword(s):  
Psychotic Symptom ◽  
Rating Scales ◽  
Symptom Dimensions ◽  
Symptom Rating

Feasibility study of culturally adapted cognitive behaviour therapy for psychosis in Pakistan

2016 ◽  
Vol 33 (S1) ◽  
pp. S578-S579 ◽  
Author(s):  
N. Husain ◽  
N. Mehmood ◽  
M.O. Husain ◽  
T. Kiran ◽  
F. Naeem ◽  
...  
Keyword(s):  
Psychotic Symptom ◽  
Low Income ◽  
Rating Scales ◽  
Intervention Group ◽  
Income Country ◽  
Psychotic Symptoms ◽  
Low Income Country ◽  
Culturally Adapted ◽  
Cognitive Behaviour ◽  
Symptom Rating

BackgroundIt is becoming well established that CBT is both effective and cost efficient in the treatment of positive and negative symptoms of schizophrenia. However, there is a need to adapt CBT to the cultural, linguistic, and socioeconomic context of diverse cultural groups. We aimed to establish the feasibility of culturally adaptive cognitive behavior therapy for treatment of psychosis in a low-income country.MethodsThis is a rater-blind, randomized, controlled trial of the use of CBT in patients with psychosis from a low-income country. Patients with a DSM-IV diagnosis of schizophreniform disorder were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Participants were randomized into the intervention group (n = 18) and TAU group (n = 18). The intervention group received 12 weekly sessions of culturally adapted CBT for psychosis (CaCBTp).ResultsThere were no significant differences between the two groups at baseline. At three months follow-up, there was a statistically significant improvement in the CaCBTp group on PANSS general Psychopathology subscale, PANSS overall score and Insight scale, as compared to the TAU group. The CaCBTp group had lower scores on PANSS positive, PANSS negative sub-scales, and the two subscales of Psychotic Symptom Rating Scale, but differences were not statistically significant.ConclusionCulturally adapted CBT added to pharmacological treatment as usual was acceptable to patients and was helpful in reduction of severity of psychotic symptoms. Adjunctive culturally adapted CBT should be further investigated in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Investigating Resilience to Depression in Adults With ADHD

2016 ◽  
Vol 22 (5) ◽  
pp. 497-505 ◽  
Author(s):  
Lauren E. Oddo ◽  
Laura E. Knouse ◽  
Craig B. H. Surman ◽  
Steven A. Safren
Keyword(s):  
Life Events ◽  
Depressive Disorders ◽  
Rating Scales ◽  
Stressful Life Events ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Adhd Symptoms ◽  
Diagnostic Interviews ◽  
Adhd Treatment ◽  
Symptom Rating

Objective: ADHD is associated with elevated rates of comorbid depressive disorders, yet the nature and development of this comorbidity remain understudied. We hypothesized that a longer period of prior ADHD treatment, being less likely to engage in maladaptive cognitive/behavioral coping strategies, and less severe ADHD symptoms would predict greater likelihood of lifetime resilience to depression. Method: Seventy-seven adults with ADHD completed diagnostic interviews, clinician-administered symptom rating scales, a stressful life events measure, and self-report questionnaires. We used logistic regression analyses to identify factors associated with resilience to depression. Results: Adults with more extensive ADHD treatment histories were more likely to be resilient to depression. Those who were less likely to report ruminative thinking patterns and cognitive-behavioral avoidance were also more resilient. Severity of current or childhood ADHD symptoms and recent negative life events did not predict resilience. Conclusion: Results identify protective factors that may promote the resiliency to ADHD-depression comorbidity.

scholarly journals Individual response to antidepressants for depression in adults – a meta-analysis and simulation study

2019 ◽  
Author(s):  
Klaus Munkholm ◽  
Stephanie Winkelbeiner ◽  
Philipp Homan
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Simulated Data ◽  
Individual Treatment ◽  
Depression Symptom ◽  
Individual Response ◽  
Inverse Variance ◽  
The Individual ◽  
Symptom Rating

Background The observation that some patients appear to respond better to antidepressants for depression than others encourages the assumption that the effect of antidepressants differs between individuals and that treatment can be personalized. Objective To compare the outcome variance in patients receiving antidepressants with the outcome variance in patients receiving placebo in randomized controlled trials (RCTs) of adults with major depressive disorder (MDD) and to illustrate, using simulated data, components of variation of RCTs. Methods From a dataset comprising 522 RCTs of antidepressants for adult MDD, we selected the placebo-controlled RCTs reporting outcomes on the 17 or 21 item Hamilton Depression Rating Scale or the Montgomery-Asberg Depression Rating Scale and extracted the means and SDs of raw endpoint scores or baseline to endpoint changes scores on eligible depression symptom rating scales. We conducted inverse variance random-effects meta-analysis with the variability ratio (VR), the ratio between the outcome variance in the group of patients receiving antidepressants and the outcome variance in the group receiving placebo, as the primary outcome. An increased variance in the antidepressant group would indicate individual differences in response to antidepressants. Results We analysed 222 RCTs that investigated 19 different antidepressants compared with placebo in 345 comparisons, comprising a total of 61144 adults with an MDD diagnosis. Across all comparisons, the VR for raw endpoint scores was 0.98 (95% CI 0.96 to 1.00, I^2^ = 0%) and 1.00 (95% CI 0.99 to 1.02, I^2^ = 0%) for baseline-to-endpoint change scores. Conclusion Based on these data, we cannot reject the null hypothesis of equal variances in the antidepressant group and the placebo group. Given that RCTs cannot provide direct evidence for individual treatment effects, it may be most reasonable to assume that the average effect of antidepressants applies also to the individual patient.

Medication use in Australian children with attention-deficit/hyperactivity disorder and autism

2021 ◽  
Author(s):  
Olivia Mellahn ◽  
Rachael Knott ◽  
Jeggan Tiego ◽  
Kathryn Kallady ◽  
Katrina Williams ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scales ◽  
Medication Use ◽  
Treatment Strategies ◽  
Autism Spectrum ◽  
Hyperactivity Disorder ◽  
Current Medication ◽  
Comorbid Adhd ◽  
Symptom Rating

Attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are commonly treated with psychotropic medications. There is however a paucity of research examining the prevalence of pharmacotherapy and polypharmacy (>2 medications) in these groups. Caregivers of 505 children (2-18 years) with ADHD (n=239), ASD (n=117) or ADHD-ASD (n=149) reported on current medication use and completed symptom rating scales. ADHD was associated with the highest rate of psychotropic medication use (90%), followed by ADHD-ASD (86%) and ASD (39%). Children with ADHD-ASD reported the highest rate of polypharmacy (41%). Although ADHD was associated with the highest overall medication use, comorbid ADHD-ASD was associated with higher odds of experiencing polypharmacy. This research should help to inform treatment strategies for children with comorbid ADHD-ASD.

scholarly journals Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

2017 ◽  
Vol 27 (3) ◽  
pp. 219-224 ◽  
Author(s):  
J. W. Keeley ◽  
W. Gaebel
Keyword(s):  
Negative Symptoms ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Severity Rating ◽  
Classification Of Diseases ◽  
The Cost ◽  
Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

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