Which are the most widely used rating scales for anxiety and depression in the setting of an outpatient psychiatry clinic?
Should I use HAM-A and HAM-D, or BAI and BDI?
Which would be most widely used in the UK? I'd be interested to know if preferences/recommendations are different elsewhere?
Also, would you recommend anything more specific for older adult patients?
I prefer BAI and BDI, but is is up to you and your purpose with your research.
GAD 7 and PHQ 9 might be good options. DASS scale you can you. For depression severity you can use Ham D rating scale.
Hi,
Depending on the study and feasibility is important in deciding upon a scale. Screening or severity rating, young or geriatric, self or rater administered, rater training required or not etc.
Snaith RP, Taylor CM. Rating scales for depression and anxiety: a current perspective. Br J Clin Pharmacol. 1985;19 Suppl 1(Suppl 1):17S-20S. doi: 10.1111/j.1365-2125.1985.tb02737.x
Hettema JM, Aggen SH, Kubarych TS, Neale MC, Kendler KS. Identification and validation of mixed anxiety-depression. Psychol Med. 2015 Oct;45(14):3075-84. doi: 10.1017/S0033291715001038
It depends on your study design and your intended participants. If you have clinical rating expertise available, then clinician-administered scales are possible, but these can be time-consuming and rely on the clinician's interviewing skills, which is something I'd hate to stake my life on.
Some self completion scales require high levels of literacy and/or concentration, and some patients find them confusing and tiring. My wife is an old age psychiatrist and they have to administer scales by interview because of difficulties with reading, concentration etc. Their experience is that several well-liked scales were just too much for the patients, and they have opted for a short scale that the patients find easy to understand and answer.
My advice, then, is to pilot a couple of scales on your intended participants and get their feedback.
The aforementioned Beck and Hamilton scales are options. However, if the question is whether an individual meets diagnostic criteria for either a major depression or specific anxiety condition, using questions based on the DSM-5 diagnostic criteria would be an option. That would give you an indication as to whether or not an individual fell into one of the diagnostic categories.
HAM-A is the best rating scale to measure the severity of anxiety symptoms
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