The Diagnostic Apathia Scale predicts the ability to return to work following depression or anxiety.

OBJECTIVE: The aim of this study was to evaluate the validity of a new apathy rating scale in predicting the ability to return to work (RTW) in patients with depression or anxiety a year after discharge from a psychiatric hospital. METHODS: We evaluated 56 patients with depression or anxiety, who participated in an on-going randomised clinical trial using RTW as primary outcome. The degree of apathy was measured by the Diagnostic Apathia Scale, which contains six items covering the following neuropsychological symptoms: concentration/memory problems, difficulties in decision making, lassitude, tiredness/fatigue, insomnia, and reduced ability to work and engage in personal interests. The scale was analysed for psychometric validity (scalability) and for its ability to predict RTW. Finally, the predictive validity of the Diagnostic Apathia Scale regarding RTW was compared with scales measuring severity of depression/anxiety symptoms, disability, and psychological well-being. RESULTS: The Diagnostic Apathia Scale displayed sufficient scalability, that is, the total score was a psychometrically valid measure of apathy. Only the Diagnostic Apathia Scale, and not the scales measuring severity of symptoms, disability, or psychological well-being, had predictive validity regarding RTW. Thus, 76% with 'clinically significant apathy' at baseline were unable to RTW versus 50% of the patients without apathy (p<0.05). CONCLUSION: The Diagnostic Apathia Scale was found to have an acceptable predictive validity in terms of patients' ability to RTW 1 year after discharge from hospitalisation for depression or anxiety.

Psychometric validation of the Hopkins Symptom Checklist (SCL-90) subscales for depression, anxiety, and interpersonal sensitivity.

BACKGROUND: The psychometric validity of many subscales of the 90-item Hopkins Symptom Checklist (SCL-90) remains largely unknown. Therefore, the aim of the present study was to evaluate the psychometric properties of the "Hamilton-subscales" for depression (SCL-D16), anxiety (SCL-A14), their 6-item core-measures (SCL-D6 and SCL-A6), the anxiety symptom scale (SCL-ASS8) and the interpersonal sensitivity scale (IPS5). METHODS: The psychometric properties of the SCL-D16, SCL-A14, SCL-D6, SCL-A6, SCL-ASS8, and the IPS5 were evaluated based on SCL-90 ratings from 850 day patients from a Danish psychiatric day hospital. The factor structure of the SCL-D16 and the SCL-A14 was investigated by means of principal component analysis (PCA) and the unidimensionality of all scales was estimated by Mokken analysis. Finally, the discriminant validity of the scales, i.e. their ability to distinguish between patients with various diagnoses, was tested. RESULTS: The PCA of the SCL-D16 and the SCL-A14 separated the core depression items from the arousal items on the SCL-D16 and the psychic anxiety items from the somatic anxiety items on the SCL-A14. According to the Mokken analyses, only the SCL-D6, the SCL-ASS8 and the IPS5 were unidimensional. Interestingly, the same three scales displayed discriminant validity for depression, anxiety disorders and personality disorders, respectively. LIMITATIONS: The study is based on data from Denmark. This may limit the validity of the results. CONCLUSIONS: Three unidimensional SCL-90 subscales were identified. Using these scales it is possible to perform a psychometrically valid evaluation of psychiatric patients regarding the severity of depression (HAM-D6), specific anxiety (SCL-ASS8) and interpersonal sensitivity (IPS5).