TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis

Table 2

Summary of the depression severity scales used in the included studies.

Instruments (no. of study)	Objective	Rater; number of item; rating scale	Categorization/cutoff
SCL-90R, DEP subscale (n = 1) [29]	To reflect the psychological symptom patterns in 9 domains: somatization/obsessive-compulsive/sensitivity/depression/anxiety/hostility/phobic anxiety/paranoid ideation/psychoticism	PRO; 90 items (DEP: n = 13); 5-point scale (0∼4)^a	A T-score^b ranging from 40 to 60 represents the normal range^c
BDI, DEP specific (n = 2) [30, 33]	To measure the severity of depression in adults and adolescents, two subscales include a cognitive-affective subscale and a somatic-performance subscale	PRO; 21 items; 4-point scale (0∼3)^a	0–13: minimal; 14–19: mild depression; 20–28: moderate; 29–63: severe^d
			In nonclinical populations, scores above 20 indicate depression
PMOS-full, DEP subscale (n = 1) [31]	To assess emotional states in 6 domains: depression/anxiety/fatigue/vigor/irritability/confusion	PRO; 65 items (DEP: n = 15); 5-point scale (0∼4)^a	Not found
PMOS-brief DEP subscale (n = 1) [32]	Same as the full version	PRO; 30 items (DEP: n = 5); 5-point scale (0∼4)^a	Not found
HAM-D DEP specific (n = 2) [26, 27]	The “gold standard” for assessing severity of depressive severity	Clinician; 17 items; 5-point scale (0–4)^a (n = 8); 3-point scale (0–2)^a (n = 9)	0–7: normal; 8–16: mild; 17–23: moderate; 24–50: severe^e
HADS DEP specific^f (n = 1) [28]	To assess anxiety and depression symptoms in medical patients	PRO; 14 items (DEP: n = 7); 4-point scale (0∼3)^a	0–7: normal; 8–10: mild; 11–14: moderate; 15–21: severe^g
			A cutoff of 8: clinically significant depression

PRO: patient-reported outcome; DEP: depression; SCL-90R: Symptom Checklist-90-Revised; BDI: Beck Depression Inventory; PMOS: Profile of Mood States; HAM-D: Hamilton Rating Scale for Depression; HADS: Hospital Anxiety and Depression Scale. ^aHigher scores indicate depressed. ^bThe SCL-90-R scores are converted to standard T-scores (ranging from 30 to 80) by referring to the appropriate population-based norm tables provided by the test manual and a T-score of 50 represents the mean of the respective normal population. ^cHoli, M. (2003). Assessment of psychiatric symptoms using the SCL-90. ^dJackson-Koku, G. (2016). Beck depression inventory. Occupational Medicine, 66 (2), 174-175. ^eZimmerman, M., Martinez, J. H., Young, D., Chelminski, I., & Dalrymple, K. (2013). Severity classification on the Hamilton Depression Rating Scale. Journal of Affective Disorders, 150 (2), 384–388. ^fAlthough the anxiety and depression questions are interspersed within the questionnaire, it is vital that these are scored separately. ^gStern, A. F. (2014). The Hospital Anxiety and Depression Scale. Occupational Medicine, 64 (5), 393–394.