Is the BPRS-5 subscale of the psychotic depression assessment scale a reliable screening tool for psychotic depression? Results from the CRESCEND Study

Seon Cheol Park, Søren Dinesen Østergaard, Joonho Choi, Jae Min Kim, Tae Youn Jun, Min-Soo Lee, Jung Bum Kim, Hyeon Woo Yim, Yong Chon Park

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Background: The detection of psychotic depression (PD) among patients with depressive disorders is important for both treatment and monitoring. Therefore, in continuation of our previous work, this study aimed to test the ability of the five-item Brief Psychiatric Rating Scale (BPRS-5) of the Psychotic Depression Assessment Scale (PDAS) in separating patients with psychotic depression from those with non-psychotic depression (non-PD) and to compare this discriminative validity to that of other item sets. Methods: A receiver operating characteristics curve was used to identify the optimal cut-off score of the BPRS-5 subscale for sensitive and specific distinction between PD and non-PD in a sample of 494 patients with depressive disorders (53 with PD and 441 with non-PD). Results: Using an optimal cut-off score of 1, the sensitivity and the specificity of the BPRS-5 subscale in detecting PD were 71.2% and 87.2%, respectively. The BPRS-5 outperformed other item sets of the PDAS and the positive symptom subscale of the BPRS in identifying patients with PD. Limitations: The inter-rater reliability of the PDAS and the BPRS-5 subscale was not evaluated in this study. Conclusions: The BPRS-5 subscale can be regarded as a more sensitive screening method for PD compared to other item sets from the PDAS and the BPRS. Hence, from a screening perspective, a positive score on any of the five symptoms of the BPRS-5 subscale (hallucinatory behavior, unusual thought content, suspiciousness, blunted affect, and emotional withdrawal) is indicative of PD, and should lead to more thorough diagnostic assessment.

Original languageEnglish
Pages (from-to)188-191
Number of pages4
JournalJournal of Affective Disorders
Publication statusPublished - 2015 Mar 15



  • Diagnostic assessment
  • Five-item Brief Psychiatric Rating Scale (BPRS-5)
  • Psychotic depression (PD)
  • Psychotic Depression Assessment Scale (PDAS)

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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