Clin Psychopharmacol Neurosci.  2017 Feb;15(1):28-34. 10.9758/cpn.2017.15.1.28.

Measurement-based Treatment of Residual Symptoms Using Clinically Useful Depression Outcome Scale: Korean Validation Study

Affiliations
  • 1Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. hancs@korea.ac.kr
  • 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Psychiatry, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 4Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Korea.
  • 5Department of Health Management, Hyupsung University, Hwaseong, Korea.
  • 6Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
  • 7Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, RI, USA.

Abstract

OBJECTIVE: This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers.
METHODS
In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic characteristics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was measured and compared with three clinician rating scales and four self-report scales.
RESULTS
The CUDOS showed excellent results for internal consistency (Cronbach's α, 0.91), test-retest reliability (patients at intake, r=0.81; depressed patients in ongoing treatment, r=0.89), and convergent and discriminant validity (measures of depression, r=0.80; measures of anxiety and somatization, r=0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classification of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores (p<0.001).
CONCLUSION
The results of this multi-site outpatient study found that the Korean version of the CUDOS is a very useful measurement for research and for clinical practice.

Keyword

CUDOS; Depression; Residual symptom; Psychometrics; Reliability and validity; Cut-off score
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