Assessment Of Severe Depression

For patients who have been diagnosed with major depressive disorder according to DSM-IV criteria, both interview- and self-report based measures are available for the assessment of depressive severity. The Beck Depression Inventory—Second Edition (BDI-II; Beck, Steer, & Brown, 1996) is perhaps the most widely used self-report measure. Beck et al. report the following ranges for depressive symptom severity: minimal (0-13), mild (14-19), moderate (20-28), and severe (29-63). Among the most widely used interview-based measures is the Hamilton Rating Scale for Depression (HRSD; Hamilton, 1960); scores on the 17-item version range in increasing severity from 0 to 69. In many clinical studies, scores of 20 or greater indicate moderate to severely depressed patients, and scores of 14 to 19 indicate less severely depressed patients. Other studies have used cutoffs of 25 or 28 to demarcate purely high-severity subgroups using the HRSD.

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