The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

Principles of Measurement Scales. DEVELOPING AND TESTING QUESTIONNAIRES. Scores and Measurements: Validity, Reliability, Sensitivity. Multi-item Scales. Factor Analysis. Item Response Theory and Differential Item Functioning. Questionnaire Development and Scoring. ANALYSIS OF QoL DATA. Cross-sectional Analysis. Exploring Longitudinal Data. Modelling Longitudinal Data. Missing Data. Quality-adjusted Survival. PRACTICAL ASPECTS AND CLINICAL INTERPRETATION. Clinical Trials. Sample Sizes. Practical and Reporting Issues. Clinical Interpretation. Appendices. References. Index.

Quality of Life: Assessment, Analysis, and Interpretation

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)66374-X.pdf

Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study

https://www.onlinejacc.org/content/accj/48/8/1527.full.pdf

Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes

background Rimonabant, a selective cannabinoid-1 receptor (CB 1 ) blocker, has been shown to reduce body weight and improve cardiovascular risk factors in obese patients. The Rimonabant in Obesity–Lipids (RIO-Lipids) study examined the effects of rimonabant on metabolic risk factors, including adiponectin levels, in high-risk patients who are overweight or obese and have dyslipidemia. methods We randomly assigned 1036 overweight or obese patients (body-mass index [the weight in kilograms divided by the square of the height in meters], 27 to 40) with untreated dyslipidemia (triglyceride levels >1.69 to 7.90 mmol per liter, or a ratio of cholesterol to high-density lipoprotein [HDL] cholesterol of >4.5 among women and >5 among men) to double-blinded therapy with either placebo or rimonabant at a dose of 5 mg or 20 mg daily for 12 months in addition to a hypocaloric diet. results The rates of completion of the study were 62.6 percent, 60.3 percent, and 63.9 percent in the placebo group, the group receiving 5 mg of rimonabant, and the group receiving 20 mg of rimonabant, respectively. The most frequent adverse events resulting in discontinuation of the drug were depression, anxiety, and nausea. As compared with placebo, rimonabant at a dose of 20 mg was associated with a significant (P<0.001) mean weight loss (repeated-measures method, i6.7±0.5 kg, and last-observation-carriedforward analyses, i5.4±0.4 kg), reduction in waist circumference (repeated-measures method, i5.8±0.5 cm, and last-observation-carried-forward analyses, i4.7±0.5 cm), increase in HDL cholesterol (repeated-measures method, +10.0±1.6 percent, and lastobservation-carried-forward analyses, +8.1±1.5 percent), and reduction in triglycerides (repeated-measures method, i13.0±3.5 percent, and last-observation-carriedforward analyses, i12.4±3.2 percent). Rimonabant at a dose of 20 mg also resulted in an increase in plasma adiponectin levels (repeated-measures method, 57.7 percent, and last-observation-carried-forward analyses, 46.2 percent; P<0.001), for a change that was partly independent of weight loss alone. conclusions Selective CB 1 -receptor blockade with rimonabant significantly reduces body weight and waist circumference and improves the profile of several metabolic risk factors in high-risk patients who are overweight or obese and have an atherogenic dyslipidemia.

https://www.nejm.org/doi/pdf/10.1056/NEJMoa044537

Effects of Rimonabant on Metabolic Risk Factors in Overweight Patients with Dyslipidemia

A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.

A. S. Zigmond

Papers

Hospital Anxiety and Depression Scale