Magazine article Clinical Psychiatry News

Rating Scales Are Just One Evaluation Tool

Magazine article Clinical Psychiatry News

Rating Scales Are Just One Evaluation Tool

Article excerpt

SANTIAGO, CHILE -- Mental health rating scales cannot replace clinical judgment, but they can be useful tools for clinicians, Dr. Martha Sajatovic said at an international congress sponsored by the World Federation of Societies of Biological Psychiatry.

Rating scales such as the Mood Disorder Questionnaire (MDQ) can be used to screen patients and identify those who need further evaluation. Other rating scales in mental health can be used to make a diagnosis, evaluate disease states, or assess short-term or long-term outcomes.

Administering a rating scale requires careful preparation by the clinician or investigator.

"Rating scales can be very helpful, but they are very dependent on the skill and the expertise of the individual administering that particular rating scale," said Dr. Sajatovic of Case Western Reserve University, Cleveland.

The individual administering the rating scale should be thoroughly familiar with the scale before attempting to interview a patient.

The rating scale should be administered in a private, quiet environment, and the patient should be prepared for the rating interview, she said.

In her own clinical practice, Dr. Sajatovic prepares the patient by explaining that "the use of a scale will not replace the conversation that you and I have, but it might help us to figure out what is going on with you and what kinds of problems you are experiencing."

The interview is often the main source of error in administering a rating scale. Failure to ask all of the questions can have a dramatic effect on the score. For example, neglecting to ask three questions on the Mini-Mental State Examination (MMSE) could result in a healthy patient appearing to have cognitive impairment. The investigator should always rate the symptoms that he or she sees without looking for explanations. If tiredness or fatigue is included as an item it should be rated, regardless of whether the patient offers explanations to account for the symptoms.

The investigator should review the items and clarify any inconsistencies before terminating the interview, particularly if the patient has given any contradictory answers. …

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