Assessment depression in primary care practice with the Beck Depression Inventory and the Hamilton Rating Scale for Depression.

Individuals suffering from depression seek help as frequently in the primary care setting as in psychiatric facilities. As primary care physicians increasingly provide such treatments, they will need to assess a patient's clinical status before, during, and after treatment. The authors evaluated the concordance and factor structures of 2 widely used depression inventories, the Beck Depression Inventory and the Hamilton Rating Scale for Depression, in a sample of primary care patients participating in a randomized, control trial of treatments for major depression. The 2 scales were significantly correlated and assessed similar rates of improvement at multiple assessment points. Factor analyses indicated that despite their equivalent assessment of severity of depression, the 2 instruments emphasize different dimensions of depression. Major depression is a common illness among medical outpatients. Studies using structured psychiatric interviews have shown that between 5% and 10% of such individuals suffer from major depression at any given time (Katon Hamilton, 1960, 1967) and the self-report Beck Depression Inventory (BDI; Beck, 1978; Beck etal., 1961). The HRSD items largely measure somatic and neurovegetative aspects of depression, whereas the BDI items focus more on the disorder's cognitive and affective dimensions. Numerous reports describe the application of these instruments in studies of psychiatric patients and their psychometric