The Carroll Rating Scale for Depression

Abstract

Research studies of depression require a measure of the severity of illness, and various rating scales or inventories have been designed in attempts to meet this need. Ratings by clinicians were introduced first, and these were complemented later by self-rating scales. The performance of these two types of rating has been compared extensively in recent years. Self ratings generally have highly significant overall correlations with clinician ratings, but some significant disagreements have been described. For example, Carroll et al. [5] found that the Hamilton Rating Scale (HAM-D) [11] completed by clinicians was superior to the Zung Self-Rating Depression Scale (SDS) [19] in discriminating global severity of depression across three treatment settings (inpatient, day hospital, general practice). Bailey and Coppen [2] found satisfactory and significant correlations between the HAM-D and the self-rated Beck Depression Inventory (BDI) [4] in only two-thirds of patients: the results in the remaining third were often very divergent. Neither type of rating scale should be used for making a diagnosis of depression [11, 5, 13], although the self-rating scales are often used as screening instruments.