Carney et al developed scales for the diagnosis of depression and the likely response to electroconvulsive therapy (ECT). The authors are from the University of Newcastle upon Tyne.
Exclusions: depression secondary to other psychosis, organic cerebral disease, epilepsy, drug addiction, or subnormality
Items for depressive scale:
(1) adequate personality (no personality deviation): free from a history of neurotic breakdown and without disabling neurotic symptoms or serious social maladjustments
(2) no adequate psychogenesis: no psychological stress or difficulty continuing to operate after the onset of symptoms and adequate to explain perpetuation of the illness.
(3) distinct quality: a quality distinct from the depression/gloom/sadness with which they usually react to adversity.
(4) weight loss
(5) previous episode of depression
(6) depressive psychomotor activity: agitation, slowing or retardation
(7) anxiety
(8) nihilistic delusions: delusions of doom, imminent destruction, somatic dissolution or poverty of the patient and/or his family
(9) blame others for illness (accusations of others)
(10) feelings guilt, delusions of guilt
Items for the ECT response scale:
(1) weight loss
(2) pyknic physique (short, thick and stocky)
(3) early wakening
(4) anxiety
(5) somatic delusions
(6) paranoid delusions
(7) worse in the PM (afternoon and evening)
(8) self pity
(9) hypochondriacal
(10) hysterical
Items shared by the 2 scales: weight loss and anxiety
|
Depression Parameters |
Finding |
Points |
|---|---|---|
|
adequate personality |
present |
1 |
|
|
absent |
0 |
|
no adequate psychogenesis |
present |
2 |
|
|
absent |
0 |
|
distinct quality |
present |
1 |
|
|
absent |
0 |
|
weight loss |
present |
2 |
|
|
absent |
0 |
|
previous episode |
present |
1 |
|
|
absent |
0 |
|
depressive psychomotor activity |
present |
2 |
|
|
absent |
0 |
|
anxiety |
present |
-1 |
|
|
absent |
0 |
|
nihilistic delusions |
present |
2 |
|
|
absent |
0 |
|
blaming others |
yes |
-1 |
|
|
no |
0 |
|
guilt |
present |
1 |
|
|
absent |
0 |
where:
• In this implementation the findings are listed as present or absent. Some versions use 3 responses (definite, possible/partial, absent) with the middle response scored based on the midpoint of the range.
depression score =
= SUM(points for all 10 parameters)
|
ECT Parameters |
Finding |
Points |
|---|---|---|
|
weight loss |
present |
3 |
|
|
absent |
0 |
|
pyknic |
present |
3 |
|
|
absent |
0 |
|
early wakening |
present |
2 |
|
|
absent |
0 |
|
anxiety |
present |
-2 |
|
|
absent |
0 |
|
somatic delusions |
present |
2 |
|
|
absent |
0 |
|
paranoid delusions |
present |
1 |
|
|
absent |
0 |
|
worse in the PM |
present |
-3 |
|
|
absent |
0 |
|
self pity |
present |
-1 |
|
|
absent |
0 |
|
hypochondriacal |
present |
-3 |
|
|
absent |
0 |
|
hysterical |
present |
-3 |
|
|
absent |
0 |
ECT score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum depression score: -2
• maximum depression score: 12
• minimum ECT score: -12
• maximum ECT score: 11
• If the depression score is >= 6, then endogenous depression is present. If <= 5, then neurotic depression is present.
• An ECT score >=1 indicates a good result from ECT, while < 1 indicates a poor outcome.
Specialty: Psychiatry
