Can a One-Item Mood Scale Do the Trick? Predicting Relapse over 5.5-Years in Recurrent Depression

BackgroundTo examine whether a simple Visual Analogue Mood Scale (VAMS) is able to predict time to relapse over 5.5-years.
Methodology/Principal Findings187 remitted recurrently depressed out-patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the 17-item Hamilton Depression rating scale (HAM-D) to verify remission status (HAM-D <10). All patients rated their current mood with the help of a Visual Analogue Mood Scale (VAMS) at baseline and at a follow-up assessment three months later. Relapse over 5.5-years was assessed by the SCID-I. Cox regression revealed that both the VAMS at baseline and three months later significantly predicted time to relapse over 5.5-years. Baseline VAMS even predicted time to relapse when the number of previous depressive episodes and HAM-D scores were controlled for. The baseline VAMS explained 6.3% of variance in time to relapse, comparable to the HAM-D interview.
Conclusions/SignificanceSad mood after remission appears to play a pivotal role in the course of depression. Since a simple VAMS predicted time to relapse, the VAMS might be an easy and time-effective way to monitor mood and risk of early relapse, and offers possibilities for daily monitoring using e-mail and SMS.
Trial RegistrationInternational Standard Randomized Controlled Trial Register Identifier: ISRCTN68246470.

研究背景：本研究旨在探究简易视觉模拟情绪量表（Visual Analogue Mood Scale, VAMS）是否能够预测5.5年随访期内的抑郁复发时间。
方法与主要结果：本研究纳入187名处于缓解期的复发性抑郁门诊患者，采用DSM-IV轴I障碍结构化临床访谈（Structured Clinical Interview for DSM-IV Axis I Disorders, SCID-I）与17项汉密尔顿抑郁量表（Hamilton Depression Rating Scale, HAM-D）对其缓解状态进行验证（要求HAM-D评分<10）。所有患者在基线及3个月随访时，均通过视觉模拟情绪量表（VAMS）评定当前情绪状态。以SCID-I评估5.5年随访期内的抑郁复发情况。Cox回归分析结果显示，基线及3个月随访时的VAMS评分均能显著预测5.5年内的复发时间；在校正既往抑郁发作次数与HAM-D评分后，基线VAMS评分仍可显著预测复发时间。基线VAMS评分可解释复发时间6.3%的变异度，与HAM-D访谈的解释力相当。
结论与意义：抑郁缓解后残留的低落情绪在抑郁病程中发挥关键作用。由于简易VAMS可有效预测复发时间，其或可成为一种简便且省时的情绪监测与早期复发风险评估工具，同时为通过电子邮件与短信开展日常情绪监测提供了可行路径。
试验注册：国际标准随机对照试验注册库编号：ISRCTN68246470。