Videotape technique in assessing antidepressants

Abstract

1 In the search for superior levels of objectivity in research in clinical psychiatry videotape (VT), recordings were made of all clinical interviews with the first eleven patients entering a double-blind controlled trial of antidepressant drugs.

2 The treating psychiatrist recorded diagnosis as listed in the ICD and described in its accompanying Glossary, and rated the Hamilton Depression Scale (HDS) at pretreatment and final interviews. A Visual Analogue Scale (VAS) for depression was independently scored by psychiatrist and patient at each interview.

3 VT recordings were despatched for independent repetition of diagnostic assessment and ratings of mood (HDS and VAS) by two further psychiatrists, creating in effect a multiple-blind study.

4 Agreement was satisfactory on ICD listed diagnoses and complete for the broad category of `affective disorder'.

5 Between the three psychiatrists, there was a high correlation of HDS scores. Patients were independently agreed to form a group of moderately depressed subjects. Closely related degrees of improvement were recorded by the three psychiatrists in all patients.

6 Correlation of scores were high for the VAS for depression as independently scored by patient, treating psychiatrist and the two VT viewers.

7 The VAS was shown to be a simple, quick and reliable indicator of depressive mood suited to repeated use at short intervals.

8 VT recordings are a useful tool in the search for higher levels of objectivity in clinical research. The technique described might well become as accepted in psychiatric drug trials as the blind control procedure.