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March 1973

Depression Rating ScalesA Critical Review

Author Affiliations

From the Department of Psychiatry, University of Melbourne, Victoria, Australia. Dr. Carroll is currently with the Depression Research Unit, University of Pennsylvania, Philadelphia.

Arch Gen Psychiatry. 1973;28(3):361-366. doi:10.1001/archpsyc.1973.01750330049009

The Hamilton Rating Scale for Depression (HRS) and the Zung Self-Rating Depression Scale (SRS) were compared in 67 depressed patients from three settings–inpatient, day hospital, and general practice. The HRS distinguished the subgroups clearly but the SRS did not. Correlations between the scales for total scores and for most individual items were not of a high order.

The low concordance between psychiatrist ratings and self-ratings is discussed with reference to their information access, sensitivity, utility, orientation, and specificity. Self-ratings may be useful for detecting the presence of symptoms but not for quantifying depression as a disorder. The Zung SRS is not recommended for use in research studies. There is a need for new self-rating depression scales oriented, like the HRS, toward the behavioral and somatic features of depressive illness.