ArticlePloS one2020
The bi-factor structure of the 17-item Hamilton Depression Rating Scale in persistent major depression; dimensional measurement of outcome.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05270915 (Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Recommendations for Research and Clinical Implementation of Ambulatory Assessment, Mood Monitoring, Digital Phenotyping, and Remote Measurement Technology in Mood Disorders: Synthesis of Systematic Review Findings.JMIR mental health · 2026Pooled it
- Bifactor exploratory structural equation modeling: A meta-analytic review of model fit.Frontiers in psychology · 2022Pooled it
- Comparison of Duloxetine Supplemented With Pregabalin and Amitriptyline Supplemented With Pregabalin for the Treatment of Postherpetic Neuralgia: A Double-Blind, Randomized Crossover Trial.CNS neuroscience & therapeutics · 2025Trial
- Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.Nature medicine · 2024Trial
- Explainable counterfactual reasoning in depression medication selection at multi-levels (personalized and population).BMC medical informatics and decision making · 2026Article
- Altered dynamic functional connectivity characteristics in adolescent depression with childhood trauma: a pilot resting-state EEG study.Frontiers in psychology · 2026Article
- The triglyceride-glucose index in relation to psychotic symptoms in adolescents with major depressive disorder.Frontiers in psychiatry · 2026Article
- Factor Analysis of the BDI-II and HAMD-21 in Patients With Irritable Bowel Syndrome.Alpha psychiatry · 2025Article
- Asthma and COPD Beyond the Airways: Exploring Neurocognitive Links Through NF-κB Subunits c-Rel and p65.International journal of molecular sciences · 2025Article
- Infant and Family Outcomes and Experiences Related to Family-Centered Care Interventions in the NICU: A Systematic Review.Children (Basel, Switzerland) · 2025Review
- Duloxetine for individuals with chronic back pain: A systematic review and meta‑analysis of randomized controlled trials.Experimental and therapeutic medicine · 2024Article
- Potential association between obstructive lung diseases and cognitive decline.Frontiers in immunology · 2024Observational
- Effects of chronotype on antidepressant treatment and symptoms in patients with depression: a multicenter, parallel, controlled study.BMC psychiatry · 2023Article
- Article
- Comparing the associations of three psychometric scales at baseline with long-term prognosis of depression over a 10-year period.International journal of methods in psychiatric research · 2022Article
- Study on the Changes in Circadian Rhythm Before and After Treatment and the Influencing Factors in Patients with Depression.Neuropsychiatric disease and treatment · 2022Article
- Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design.Frontiers in pediatrics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe 17-item Hamilton Depression Rating Scale (HDRS17) is used world-wide as an observer-rated measure of depression in randomised controlled trials (RCTs) despite continued uncertainty regarding its factor structure. This study investigated the dimensionality of HDRS17 for patients undergoing treatment in UK mental health settings with moderate to severe persistent major depressive disorder (PMDD).
methodsExploratory Structural Equational Modelling (ESEM) was performed to examine the HDRS17 factor structure for adult PMDD patients with HDRS17 score ≥16. Participants (n = 187) were drawn from a multicentre RCT conducted in UK community mental health settings evaluating the outcomes of a depression service comprising CBT and psychopharmacology within a collaborative care model, against treatment as usual (TAU). The construct stability across a 12-month follow-up was examined through a measurement equivalence/invariance (ME/I) procedure via ESEM.
resultsESEM showed HDRS17 had a bi-factor structure for PMDD patients (baseline mean (sd) HDRS17 22.6 (5.2); 87% PMDD >1 year) with an overall depression factor and two group factors: vegetative-worry and retardation-agitation, further complicated by negative item loading. This bi-factor structure was stable over 12 months follow up. Analysis of the HDRS6 showed it had a unidimensional structure, with positive item loading also stable over 12 months.
conclusionsIn this cohort of moderate-severe PMDD the HDRS17 had a bi-factor structure stable across 12 months with negative item loading on domain specific factors, indicating that it may be more appropriate to multidimensional assessment of settled clinical states, with shorter unidimensional subscales such as the HDRS6 used as measures of change.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.