Use of depression rating scales in chronic fatigue syndrome

Abstract

Objective: The aim of this study was to examine the performance of three commonly used depression rating scales in a hospital sample of patients with chronic fatigue syndrome (CFS). Methods: Sixty-one patients with CDC criteria for CFS completed the General Health Questionnaire (GHQ), the Hamilton Depression Scale (HAM-D) and the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Current psychiatric status was assessed using the Structured Clinical Interview for DSM-III-R. Disorders: Patient version (SCID-P). Receiver operating curves were drawn for each of the depression rating scales. Results: Thirty-one percent of the patients were depressed according to the SCID-P. Using the standard cut-offs, both GHQ and HAM-D overestimated the number of depressed patients, whilst the HADS-D underestimated the number. The receiver operating curves suggest that the optimum cut-offs for GHQ, HAM-D and HADS-D in this population are 7/8, 13/14 and 8/9, respectively. Conclusions: Standard cutoffs may not be appropriate when using depression rating scales in CFS patients in a tertiary care setting. © 2005 Elsevier Inc. All rights reserved.