Trends in (not) using scales in major depression: A categorization and clinical orientation

BACKGROUND: Standard depression rating scales like the Hamilton Depression Rating Scale and the Montgomery–Åsberg Depression Rating Scale were developed more than 40 years ago. They are mandatory in clinical trials but are for a variety of reasons seldom used in clinical practice. Moreover, most clinicians are less familiar with more recent trends or with some dilemmas in assessment tools for major depression. METHODS: Narrative review. RESULTS: Asssessment tools can be observer-rating or self-rating scales, disease-specific or non–disease-specific scales, subjective scales or objective lab assessments, standard questionnaires or experience sampling methods. An overarching question is to what degree current assessment methods really address the individual patient’s needs and treatment expectations. CONCLUSIONS: The present paper aims to offer a framework for understanding the current trends in assessment tools that can orientate and guide the clinician.