Rating Scales for Depression

Over the past few decades, a number of clinician-rated and patient-rated instruments have been developed as primary efficacy measures in depression clinical trials. All those scales have relative strengths and weaknesses and some of them have been more successful than others, and have become the gold standards for depression clinical research. With all these measures available and with the evidence of their variable performance in clinical trials, it is becoming increasingly important to select primary efficacy measures that are reliable, valid, and that fit well within the aims of depression clinical trials. This article will review the main considerations that investigators need to make when choosing a primary efficacy measure for major depressive disorder (MDD). There is a clear need for a thorough discussion of the methodological issues concerning the use of these scales, as suggested also by Demyttenaere and De Fruyt in a recent review [1], because clinical trials researchers in depression continue to struggle with the ability to detect signals of the efficacy of antidepressant agents.