The Newcastle Diagnostic and ECT Scales of Carney et al for Depression

Exclusions: depression secondary to other psychosis, organic cerebral disease, epilepsy, drug addiction, or subnormality

 

Items for depressive scale:

(1) adequate personality (no personality deviation): free from a history of neurotic breakdown and without disabling neurotic symptoms or serious social maladjustments

(2) no adequate psychogenesis: no psychological stress or difficulty continuing to operate after the onset of symptoms and adequate to explain perpetuation of the illness.

(3) distinct quality: a quality distinct from the depression/gloom/sadness with which they usually react to adversity.

(4) weight loss

(5) previous episode of depression

(6) depressive psychomotor activity: agitation, slowing or retardation

(7) anxiety

(8) nihilistic delusions: delusions of doom, imminent destruction, somatic dissolution or poverty of the patient and/or his family

(9) blame others for illness (accusations of others)

(10) feelings guilt, delusions of guilt

 

Items for the ECT response scale:

(1) weight loss

(2) pyknic physique (short, thick and stocky)

(3) early wakening

(4) anxiety

(5) somatic delusions

(6) paranoid delusions

(7) worse in the PM (afternoon and evening)

(8) self pity

(9) hypochondriacal

(10) hysterical

 

Items shared by the 2 scales: weight loss and anxiety

 

Depression Parameters	Finding	Points
adequate personality	present	1
	absent	0
no adequate psychogenesis	present	2
	absent	0
distinct quality	present	1
	absent	0
weight loss	present	2
	absent	0
previous episode	present	1
	absent	0
depressive psychomotor activity	present	2
	absent	0
anxiety	present	-1
	absent	0
nihilistic delusions	present	2
	absent	0
blaming others	yes	-1
	no	0
guilt	present	1
	absent	0

 

where:

• In this implementation the findings are listed as present or absent. Some versions use 3 responses (definite, possible/partial, absent) with the middle response scored based on the midpoint of the range.

 

depression score =

= SUM(points for all 10 parameters)

 

ECT Parameters	Finding	Points
weight loss	present	3
	absent	0
pyknic	present	3
	absent	0
early wakening	present	2
	absent	0
anxiety	present	-2
	absent	0
somatic delusions	present	2
	absent	0
paranoid delusions	present	1
	absent	0
worse in the PM	present	-3
	absent	0
self pity	present	-1
	absent	0
hypochondriacal	present	-3
	absent	0
hysterical	present	-3
	absent	0

 

ECT score =

= SUM(points for all 10 parameters)

 

Interpretation:

• minimum depression score: -2

• maximum depression score: 12

• minimum ECT score: -12

• maximum ECT score: 11

• If the depression score is >= 6, then endogenous depression is present. If <= 5, then neurotic depression is present.

• An ECT score >=1 indicates a good result from ECT, while < 1 indicates a poor outcome.