SCALES IN PSYCHIATRY

Presented by DR.DRON BHATIA

INTRODUCTION

 Psychiatrists often use various scales to help assess and quantify different aspects of
mental health conditions. These scales can be helpful in providing a standardized way to
measure symptoms, track progress, and guide treatment decisions.
 some commonly used scales in psychiatry:
Hamilton Rating Scale for Depression (HAM-D): This scale is used to assess the
severity of depression. It includes 21 items related to symptoms such as mood, guilt,
sleep, and appetite.
Beck Depression Inventory (BDI): This self-report questionnaire measures the severity
of depression symptoms. It consists of 21 items that assess symptoms such as sadness,
hopelessness, and loss of interest.
Generalized Anxiety Disorder 7-item (GAD-7) scale: This scale is used to assess
anxiety symptoms. It includes seven items related to symptoms such as worry,
nervousness, and restlessness.
Yale-Brown Obsessive-Compulsive Scale (Y-BOCS): This scale is used to assess the
severity of obsessive-compulsive disorder (OCD) symptoms. It includes 10 items related
to obsessions and compulsions.
Positive and Negative Syndrome Scale (PANSS): This scale is used to assess the severity
of symptoms in patients with schizophrenia. It includes 30 items related to positive
symptoms (such as hallucinations and delusions), negative symptoms (such as flat affect
and lack of motivation), and general symptoms (such as anxiety and depression).
 These scales can provide valuable information to help diagnose mental health conditions,
monitor treatment progress, and guide treatment decisions. However, it's important to
note that scales are just one tool among many that psychiatrists use to assess and treat
mental health conditions. A comprehensive evaluation, including a thorough clinical
interview and other assessments, is necessary for accurate diagnosis and treatment
planning
HAM-D

 The Hamilton Rating Scale for Depression (HAM-D) is one of the most widely
used scales for assessing the severity of depressive symptoms in adults. It was
developed by Max Hamilton in 1960 and has since undergone several revisions to
improve its validity and reliability.
 The HAM-D consists of 21 items that assess a range of depressive symptoms, such
as depressed mood, guilt feelings, insomnia, agitation, and loss of interest or
pleasure. Each item is rated on a scale of 0 to 2, 0 to 3, or 0 to 4, depending on the
severity of the symptom. The total score ranges from 0 to 54, with higher scores
indicating more severe depressive symptoms.
BDI

 The Beck Depression Inventory (BDI) is a self-reported questionnaire developed by

Aaron T. Beck to assess the severity of depressive symptoms in adults and
adolescents. The BDI was first published in 1961 and has since undergone several
revisions to improve its validity and reliability.
 The BDI consists of 21 items that assess a range of depressive symptoms, such as
sadness, pessimism, guilt feelings, loss of interest or pleasure, and suicidal
thoughts. Each item is rated on a scale of 0 to 3, with higher scores indicating more
severe depressive symptoms. The total score ranges from 0 to 63.
GAD-7

 The Generalized Anxiety Disorder 7-item (GAD-7) scale is a brief self-reported

questionnaire used to assess the severity of generalized anxiety disorder (GAD)
symptoms in adults. The GAD-7 was developed by Kurt Kroenke, Robert L.
Spitzer, and Janet B.W. Williams in 2006.
 The GAD-7 consists of seven items that assess symptoms such as feeling nervous,
worrying too much, and being unable to relax. Each item is rated on a scale of 0 to
3, with higher scores indicating more severe symptoms. The total score ranges from
0 to 21, with scores of 5, 10, and 15 indicating mild, moderate, and severe anxiety,
respectively.
Y-BOCS

 The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a standardized,

clinician-administered assessment tool used to measure the severity of obsessive-
compulsive disorder (OCD) symptoms. The Y-BOCS was developed by Wayne K.
Goodman and his colleagues at Yale University in 1989.
 The Y-BOCS consists of 10 items that assess the severity of both obsessions (e.g.,
recurrent, intrusive thoughts, images, or impulses) and compulsions (e.g., repetitive
behaviors or mental acts) on separate scales. Each item is rated on a 5-point scale,
ranging from 0 (no symptoms) to 4 (extreme symptoms), based on the patient's
reports and the clinician's observations. The total score ranges from 0 to 40 for both
the obsession and compulsion scales, with higher scores indicating more severe
symptoms.
PANSS

 The Positive and Negative Syndrome Scale (PANSS) is a standardized, clinician-

administered assessment tool used to evaluate the severity of symptoms in patients
with schizophrenia. The PANSS was developed by Stanley Kay, Lewis Opler, and
Abraham Fiszbein in 1987.
 The PANSS consists of 30 items that assess three main domains of schizophrenia
symptoms: positive symptoms (e.g., hallucinations, delusions), negative symptoms
(e.g., lack of emotion, social withdrawal), and general symptoms (e.g., anxiety,
depression). Each item is rated on a 7-point scale, ranging from 1 (absent) to 7
(extreme), based on the clinician's observations and the patient's reports. The total
score ranges from 30 to 210, with higher scores indicating more severe symptoms.