RATING SCALES Flashcards
An all-purpose screening tool used as a first-level assessment epidemiological studies?
Goldberg introduced the General Health Questionnaire (GHQ)
versions using 12, 28, 30 or 60 items (28 most common)
Hopkins Symptom Check List (HSCL)
Patient health questionannire
HSCL - Trained primary care workers
- 58 item self report version
PHQ- self-report version of Primary Care Evaluation of Mental Disorders (PRIME-MD) developed by Spitzer et al. on the basis of DSM-III.
diagnositc schedules-
Clinical Interview Schedule (CIS)
Composite International Diagnostic Interview (CIDI)
Used in National Psychiatric Morbidity Surveys of Great Britain. Developed by Goldberg et al.
CIDI - an improvised schedule that incorporated principles of both PSE and DIS. It was produced by WHO to be used with both ICD and DSM diagnoses
Patient State Exam (PSE)
Schedule for Affective Disorders and Schizophrenia (SADS)
Schedule for Assessment in Neuropsychiatry (SCAN)
PSE- Provides clinical diagnoses in the lines of ICD system.
SADS- Covers all major mental illnesses clinician semi-structured
SCAN- Developed by Wing et al. on the basis of PSE and has replaced PSE at present.
Depression Rating Scales
2 Questions scale (also called PHQ-2)
HAMD/HDRS- Hamilton depression rating scale
Montgomery
1) “Over the past two weeks, have you ever felt down, depressed, or hopeless?” and
(2) “Have you felt little interest or pleasure in doing things?”
HDRS - = severity of depression
Montgomery- Observer rated 17-21, last 2 weeks - More biological items
Depression scale
Beck depression inventory
Zung depression inventory
Visual Analogue Scale (VAS)
Beck- self rating 21 items, max score 63, last 2 weeks
0 minimal, >28 severe.
More psychological features
Zung
- 20 items, self rated.
Avoids psychological imbalance from becks
poor correlation with observer rating
Insensntivie to change
VAS - 10cm line hwere patient indicates state of mood
Reynolds Child Depression Scale (8-12)
Children’s Depression Inventory (7-17 years)
Mood and Feelings questionnaire (8-18 years
RCHD and CDI- both developed for children with lower reading levels
MFQ- endorsed by nICE- has self and parent rated versions - for children
Perinatal depression:
Edinburgh Postnatal Depression Scale was specifically developed for assessing postpartum depression and relies much less on somatic questions.
Questions on the Edinburgh scale (10 items, can be self or clinician-rated) are framed within the “past seven days”, and response is frequency-based.
- Routine use of EPDS postpartum = shown to increase the detection of postpartum depression
Geriatric depression
If cognitive defects?
The GDS – Geriatric depression scale was specifically developed for use in geriatric patients, and it contains fewer somatic items
Questions pertain to symptoms within the
past week, and responses require only a “yes” or ‘no’
If cognitive defects
- interviewed administer preferred eg Hamilton or Cornell scale (administered by primary caregiver)
Depression in schizophrenia:
Calgary Depression Scale for Schizophrenia (CDSS) focuses on symptoms of depression in
the presence of schizophrenia.
Alcohol rating scales
CAGE Questions: cut down, annoyed guilty, early morning?
AUDIT: Alcohol Use Disorders Identification Test
10 questionnaire. 8+ harmful, 13+w and 15+ men = dependent, WHO + GP
MAST: Michigan Alcohol Screening Test
25 item test. 6+ problem.
CIWA: Clinical Institute Withdrawal Assessment for Alcohol
- clinicoians Rate severity withdrawal eg nausea, sweating
CAMHS scales
- Child adolescent functional assessment scale
- Child Behavior Checklist
Diagnostic Interview schedule children
Conners rating scales
- C+A Functional assessment- degree of impairment in functioning due to emotional. behaviour/ psych. completed by clinical staff. 10 mins. conduct problems measured aged 7-17
- CBCL- 4 - 16 yrs - records behavioural problems reported by parents or teachers
DISC- interview for making dSM based diagnoses
CRS- family if instruments that measure psychopathology-
Scales used in old age psychiatry
The Geriatric Mental State Schedule (GMSS)
The Mini-Mental State Examination (MMSE)
Abbreviated Mental Test Score
The Alzheimer’s Disease Assessment Scale (ADAS)
The BEHAVE—AD i
The Geriatric Mental State Schedule (GMSS)- community surveys
The Mini-Mental State Examination (MMSE) - 10 mins to do, 23 cut off score for impairment. educational status affected this.
Abbreviated Mental Test Score- 10 point questionaire 7/10 dementia
The Alzheimer’s Disease Assessment Scale (ADAS) - gold standard for measuring change in cognitive function in anti-dementia drug trials
The BEHAVE—AD - document behaviour syx alzheimers
Scales used in old age psychiatry
The Neuropsychiatric Inventory (NPI)
MOUSEPAD stands for Manchester and Oxford Universities Scale for the Psychopathological
Assessment of Dementia
Clifton assessment procedure for the elderly - CAPE (Pattie & Gilleard, 1979)
Bristol Activities of Daily Living Scale
The Neuropsychiatric Inventory (NPI) - severity behavioural syx dementia
MOUSEPAD stands for Manchester and Oxford Universities Scale for the Psychopathological
Assessment of Dementia- administered by carers
Clifton assessment procedure for the elderly - CAPE (Pattie & Gilleard, 1979) - assess level of disability
Bristol Activities of Daily Living Scale- assesses 20 aDLS in patients w dementia
positive and negative symptom scale (PANSS)
Yale-Brown obsessive compulsive scale (Y-BCOS)
For assessment of severity and monitoring of change of
symptoms in patients with a diagnosis of schizophrenia. 30 items are covering positive symptoms
Clinician done
clinician done, allowing rating with pre existing diagnosis OCD
SCOFF
A mnemonic for eating disorder screening
1. make self Sick
2. Control
3. lost ONE stones worth weight
4. believe you are FAT
5. FOOD dominates life
Minnesota Multiphasic
Personality inventory
A self report consisting of 567 questions
covering 8 areas of psychopathology, 2 additional areas of
personality type, and 3 scales assessing truthfulness. Results
are compared with normative data from non-clinical populations.
NOT A PROJECTIVE TEST
International Personality
Disorder Examination
(IPDE)
Semi-structured
clinical interview for
use by clinicians
producing ICD-10-
personality disorder
diagnosis.
67 standardized probe questions. 57-item true/false
questionnaire also included for screening purposes
Clinical Global
Improvement (CGI
Clinician rated based
on clinical judgment
A two-item instrument - CGI-S (severity) – the current
condition on a scale of 1–7 & CGI-I (improvement) – the
extent of improvement since the start of treatment on a scale of 1–7.
Can be used for any psychiatric disorder
encountered in a clinic or ward.
Brief Psychiatric Rating
Scale (BPRS)
One of most widely used
clinical rating scales. Originally intended for use in
clinical trials of new psychotropic drugs.
- The ratings include
observations as well as patient reports.
Scale for Assessment of
Positive Symptoms
(SAPS) and the Scale for
Assessment of Negative
Symptoms (SANS)
Clinician rated based on clinical interview
- looks at neurobiological correlates of symptom groupings.
Personality Diagnostic
Questionnaire-4+ (PDQ4+)
Self-report instrument
assessing 12 personality disorders
Outcome scores
- Global Assessment of Functioning Scale (GAF)
Social and Occupational Functioning Assessment Scales (SOFAS)
Short form helath survey 36- SF-36
Health of national outcome scales
GAF- self report and clinical interview. Function and syx.
SOFAS- like GAF but only focuses on functioning, no syx.
Short form helath survey 36- SF-36- wide range settings, 14 yrs+/ interviewer, assesses 8 health concepts
Health of national outcome scales - HONOS- most widely used psychiatric outcome scale in NHS - 12 items measuring behaviour, impairment, sy and social functioning. uses routine clinical assessments.
Reliability can be assessed by…
Cronbach’s alpha measures..
The intraclass correlation coefficient is used for…
test-retest correlation
..internal consistency
..Continuous variables
Construct validity
Made up of..
Measures whether a test really measures the (theoretical) construct of
interest or something else
Content validity - is it measuring what its meant to
Criterion validity - is it good against another instrument
Structured Risk tools
- HCR-20 (Webster)
- SARA - Spousal assault risk assessment guide
- SVR-20 - sexual violence risk scale
HCR-20 (Webster) - tool for violence- 10 historical items, 5 clinical items, 5 risk management items
- SARA- help gauge risk of future violence in men arrested for spousal assault
- SVR-20- Sexual violence risk scale - assessing risk in sex offenders
- SADPERSONS score
- Beck hopelessness scale
- Beck Scale for suicidal ideation
- SADPERSONS score - assess immediate suicidal risk in acute general hospital setting,
- Beck hopelessness scale- 20 true-false statements about negativity to future.
- Beck Scale for suicidal ideation- self report to assess plans to commit suicide.
Actuarial instruments examples
VRAG Violence risk appraisal guide
Manchester Self harm rule
Sore- sexual risk offender appriaisal guide
Static-99
group data applied to patient in question
