Rating scales in psychiatry
Measuring the intangible
Behavior is anything a human does that can be observed. What can be observed can also be measured. Thus measuring behavior in a patient as an outcome of action (some form of behavior therapy, medicine, shock therapy, trans-cranial magnetic stimulation and many more) is possible, albeit not so easy. Prior to behavior comes emotional experience and prior to that too, is thought processing. Understanding intangible concepts is a daunting task as there is no test or scan that quantifies depression or delusions or quality of one’s life.
Using psychiatric rating scales
Several rating scales have been devised to accurately measure our three abstract variables (thinking, feeling and behaving) in humans. Extensive research goes into examining their psychometric properties and developing guidelines for applying them sensitively. Research in mental health pharmacology over the past few decades has been promising and search for better medication for psychiatric medication is an ongoing need of the hour. It is important for clinical trial staff to gain an understanding of these measurement tools, to quantify the success of their investigational new drug’s (IND’s) efficacy.
Psychometrics (psycho = of the mind, metrics = measurement) involves the measurement of psychological constructs of the mind. Some scales are diagnostic i.e. they are administered to diagnose the presence or absence of the psychiatric problem; while others are prognostic i.e. they are applied only after the diagnostic scales have confirmed the presence of illness and subsequent progress needs to be quantified to monitor symptom change over time.
The MINDFRAMES experience
Appropriate selection of rating scales is a critical decision during the formulation of clinical trial protocols especially when the variables in context are as intangible as in psychiatric disorders. We have offered research expertise to global pharmaceutical companies in the form of training seminars, interactive group discussions with the trial sponsor staff as well as medical review of documents and rating tools for international clinical research. Interaction of study sponsors with experts from the clinical field can be quite an enriching experience involving information exchange and enlightenment about patient concerns.