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J Nerv Ment Dis. 2009 Sep;197(9):682-6. doi: 10.1097/NMD.0b013e3181b3b3a0.

Validity and reliability of the Hamilton depression rating scale (5 items) for manic and mixed bipolar disorders.

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  • 1CIBERSAM Stanley Institute International Mood Disorders Research Center, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Alava, Spain.


Depressive symptoms during mania have prognostic value in bipolar disorder. For depressive symptoms, it has been proposed that shorter scales should be cost-effective and practical. To determine the usefulness of 5-item Hamilton Depression Rating Scale (HAMD-5) in manic and mixed bipolar disorder, we used a four-week follow-up prospective, observational study. Convergent and discriminant validity, internal consistency, and reliability were analyzed and compared with HAMD-21, HAMD-5, and HAMD-21 cut-off points were calculated versus CGI-BP. A total of 173 manic and mixed patients were evaluated. HAMD-5 showed appropriate convergent validity, discriminant validity, internal consistency, and test-retest reliability. Discriminant validity was higher for HAMD-5 than HAMD-21. Best cut-off point of remission was: HAMD-21 < or =5 and HAMD-5 < or =1. HAMD-5 presents appropriate validity and reliability estimates. It is comparable to HAMD-21 and focuses more specifically on depressive symptoms.

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