Reference values for major depression questionnaires: The Leiden Routine Outcome Monitoring Study

Schulte-van Maaren, Yvonne W.M.; Carlier, Ingrid V.E.; Zitman, Frans G.; van Hemert, Albert M.; de Waal, Margot W.M.; van der Does, A.J. Willem; van Noorden, Martijn S.; Giltay, Erik J.

doi:10.1016/j.jad.2013.02.009

Cited by 62Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionPsychometric Methodologies and Testing

Reference values for major depression questionnaires: The Leiden Routine Outcome Monitoring Study

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Schulte-van Maaren, Yvonne W.M., Carlier, Ingrid V.E., Zitman, Frans G., van Hemert, Albert M., de Waal, Margot W.M., van der Does, A.J. Willem, van Noorden, Martijn S., Giltay, Erik J.·2013·Journal of Affective Disorders

DOI 10.1016/j.jad.2013.02.009

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Abstract

Background The Beck Depression Inventory-II (BDI-II), the Inventory of Depressive Symptoms (self-report) (IDS-SR) and the Montgomery-Äsberg Depression Rating Scale (MADRS) are questionnaires that assess symptom severity in patients with a depressive disorder, often part of Routine Outcome Monitoring (ROM). We aimed to generate reference values for both "healthy" and "clinically depressed" populations.Methods We included 1295 subjects from the general population (ROM reference-group) recruited through general practitioners, and 4627 psychiatric outpatients diagnosed with Major Depressive Disorder (MDD) or dysthymia (ROM patient-group). The outermost 5% of observations were used to define limits for one-sided reference intervals (95th percentiles; P95). Receiver Operating Characteristics (ROC) analyses were used to yield alternative cut-off values. Internal consistency was assessed.Results The mean age was 40.3yr (SD=12.6) and 39.3 (SD=12.3) for the ROM reference and patient-groups, respectively, and 62.8% versus 61.0% were female. Cut-off (P95) values differed for women and men, being respectively 15 and 12 for the BDI-II, 23 and 18 for the IDS-SR, and 12.5 and 9 for the MADRS. ROC analyses yielded almost equal reference values. The discriminative power of the BDI-II, IDS-SR and MADRS scores was very high. Internal consistency was excellent for total scores and satisfactory for all subscales, except for the IDS-SR subscale Atypical Characteristics.Limitations Substantial non-response and limited generalizability.Conclusions For the BDI-II, IDS-SR and MADRS a comprehensive set of reference values were provided. Reference values were higher in women than in men, implying the use of sex-specific cut-off values. Either instrument can be offered to every patient with MAS disorders to make responsible decisions about continuing, changing or terminating therapy.

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The QIDS-SR16 has been validated in a Dutch clinical population.
“The QIDS-SR16 has been validated in a Dutch clinical population [33].”
From Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive–compulsive disorder: a study protocol for a randomized controlled trial (2024) · cites this paper as [33]
The Procedures and instruments section describes the 30-item IDS-SR, not the QIDS-SR16; the Discussion and conclusion identifies reference values and reliability coefficients for the BDI-II, IDS-SR, and MADRS. A QIDS-SR psychometric evaluation appears in the References, but no passage found in our copy says the QIDS-SR16 was validated in a Dutch clinical population (searched: QIDS-SR16, QIDS-SR, and Dutch validation). (LLM, conf=0.76)
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Reference values for generic instruments used in routine outcome monitoring: the leiden routine outcome monitoring study
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A study of the psychometric properties of the Beck Depression Inventory‐ II , the Montgomery and Åsberg Depression Rating Scale, and the Hospital Anxiety and Depression Scale in a sample from a healthy population
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Authors: Schulte-van Maaren, Y. W. M., Carlier, I. V. E., Zitman, F. G., van Hemert, A. M., de Waal, M. W. M., van der Does, A. J. W., van Noorden, M. S., & Giltay, E. J.
Affiliations: Leiden University Medical Center (NL)
ORCID: Carlier, Ingrid V.E.
Zitman, Frans G.
Giltay, Erik J.
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2013-07
Volume: 149
Issue: 1-3
Pages: 342-349
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2013.02.009
OpenAlex: W2091522611
Cited by: 62
References: 69
Citations by year: 2026: 1 · 2025: 1 · 2024: 9 · 2023: 4 · 2022: 4 · 2021: 11 · 2020: 8 · 2019: 4 · 2018: 7 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 1
FWCI: 4.06
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 332 d)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Leiden Repository (Leiden University) (submittedVersion)
Funders: Rivierduinen, a regional mental health care provider in the Netherlands
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: reference values, major depressive disorder, dysthymia, Beck Depression Inventory-II, Montgomery-Asberg Depression Rating Scale, routine outcome monitoring, cut-off values, sex differences, depression severity, general population, psychiatric outpatients
MeSH terms: Adult, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Reference Values, Outcome Assessment, Health Care

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