Evaluating major depressive episodes through the algorithmically structured systematic exploration of subject's state of mind.

BACKGROUND/AIMS: Whereas instruments are available to diagnose depression and to rate its severity, there is a lack of instruments to assess the phenomenology of depression, i.e. a set of mental phenomena that constitute subjective experience. The Algorithmically Structured Systematic Exploration of Subject's State of Mind (Assess_Mind) is based on open questions asked via a structured algorithm. Here, we evaluated its reliability and its validity to assess the phenomenology of major depressive episodes.

METHODS

Scales were constructed to evaluate various aspects of major depressive episodes, and an Assess_Mind score was derived from these scales. Thirty-five patients presenting a major depressive episode were assessed with the Hamilton Depression Rating Scale, Clinical Global Impressions (CGI) scale, Beck Depression Inventory and Symptom Checklist-90R. Two series of assessments were conducted, separated by 3 weeks.

RESULTS

Interrater reliability was good to excellent and test-retest reliability was acceptable. Whereas construct validity was poor at the first time point (first day of the patient's inclusion), it was adequate for the second day and 3 weeks later. The change in the Assess_Mind score predicted the change in the CGI rating as well as the other instruments did. These results should be confirmed in larger samples.

CONCLUSION

The Assess_Mind provided a useful assessment of the phenomenology of depression and of the course of major depressive episodes.