Psychometric properties of responses by clinicians and older adults to a 6-item Hebrew version of the Hamilton Depression Rating Scale (HAM-D6)

A total of 153 Israelis 75？years of age on average participated in this study. The HAM-D6 was examined using confirmatory factor analytic (CFA) models separately for both patient and clinician responses.Reponses to the HAM-D6 suggest that this instrument measures a unidimensional construct with each of the scales’ six items contributing significantly to the measurement. Comparisons between self-report and clinician versions indicate that responses do not significantly differ for 4 of the 6 items. Moreover, 100% sensitivity (and 91% specificity) was found between patient HAM-D6 responses and clinician diagnoses of depression.These results indicate that the Hebrew HAM-D6 can be used to measure and screen for depressive symptoms among elderly patients.Depression is a common debilitative psychiatric condition ranked high in prevalence among all mental health conditions [1]. Lifetime prevalence may be as high as 20% [2] and, at any one time, 5–10% of the world’s population meets diagnostic criteria for a major depressive episode [3]. Depression is projected to be the second leading cause of disability worldwide in 2020 [4].Clinical depression is common in primary care with rates of prevalence among older adults ranging between 4–24% [5,6]. Untreated elderly patients are at higher risk of morbidity and mortality [7] and experience slower rates of recovery [6,8]. Moreover, chronic depression is a significant risk factor for dementia [9].Given that depression is amenable to treatment, valid and reliable screening tools are necessary to identify this patient population. Among existing instruments, the clinician-administered Hamilton Depression Rating Scale (HAM-D) was first developed to assess the efficacy of the first generation of antidepressant medications [10]; the HAM-D has since become the gold standard for measuring symptom severity and change in randomized clinical trials. Among various formats (17, 21, 24 & 28 items) [10,11], the 17-item (HAM-D17) has been used most