In the original scoring system, however, the two of the depression items (item 6 and 10) may undermine a precise evaluation of depressive level as suggested by the low contributions to the depression factor.
These factors were depression (factor 1), mania (factor 2), sleep disturbance (factor 3), judgment/impulsivity (factor 4), and irritability/hostility (factor 5) (Swann et al. 2013b).
These findings are consistent with CFA analyses showing significant covariance between affrontive symptoms of mania and both cognitive and somatic symptoms of depression, and no covariance between elation/loss of insight and either depression factor.
Improvements in depression factor scores versus placebo showed a trend for improvement for aripiprazole at week 3 (study endpoint), but the changes did not reach statistical significance (Figure 2). Figure 1 Effects of treatment (versus placebo) on factor scores from baseline to week 3 of treatment*.
The depression factor has good internal consistency (α =.81, [ 71].
Under this model, Negative Affect (NA), a mixed anxiety-depression factor, explains the comorbidity between these syndromes.
This factor accurately described depressive symptoms, so it was named 'depression.' Factor 2 was comprised of eight items (items 2, 3 6, 18 20), these being questions about persistent headaches, feeling easily frightened, hands shaking, poor sleep, feeling nervous, tense, and worried, becoming easily tired, and uncomfortable feelings in the stomach.
In the primary trials, depression severity was assessed using the MADRS, the Positive and Negative Syndrome Scale (PANSS) Marder anxiety/depression factor, and the CGI-BP-D scale.
Improvement was seen in all depression endpoints (change from baseline on MADRS total score, CGI-BP-D CGI-BP-D CGI-BP-Dnd PANseverityr anxiety/deprescore fandor score), as well as on MADRS remission rate.
The factor analysis suggested four factors: "Functioning" (loading by SOFI, QLS, and PANSS negative), "Daily Living" (loading by SOFI), "Depression" (loading by MADRS, PANSS anxiety/depression factor, and SWN-K negatively-asked questions), and "Psychopathology" (loading by PANSS negative and positive symptoms, disorganized thoughts, and hostility/excitement factors).
