Introduction
The Inventory of Depressive Symptomatology – Clinician-Rated (IDS-C) is a 28-item clinician-rated measure of the specific signs and symptoms of depression in inpatients and outpatients. A. John Rush and colleagues published it in 1986. It is matched item by item to its self-report version, the IDS-SR, and the original article has received at least 1,200 citations.
The developers worked at the Affective Disorders Unit and Department of Psychiatry, University of Texas Health Science Center at Dallas, and the study appeared in Psychiatry Research. This guide explains what the IDS-C covers, how clinicians score it, and what the preliminary evidence shows.
Key Features of the IDS-C
Purpose and Use
The IDS-C measures specific signs and symptoms of depression from the clinician's perspective. In the original study, clinicians administered it to 82 outpatients, most with unipolar or bipolar depression. The authors describe these findings as preliminary.
Target Population
The IDS-C is intended for adults with depression, including unipolar major depression and bipolar depression. It also captures endogenous, atypical and anxious features of depression.
Structure
The IDS-C contains 28 items, of which 26 count toward the total. This is because clinicians complete only one appetite item (decreased or increased) and one weight item (decrease or increase). The items cover five areas:
Vegetative symptoms: sleep-onset, mid-nocturnal and early-morning insomnia, hypersomnia, appetite and weight changes, sexual interest, and psychomotor slowing and agitation.Cognitive changes: concentration and decision-making, outlook for self, outlook for the future, and suicidal ideation.Mood disturbance: sad, irritable and anxious mood.Endogenous features: reactivity of mood, mood variation, quality of mood, involvement, energy and fatigability, and pleasure or enjoyment.Anxiety and somatic symptoms: somatic complaints, sympathetic arousal, panic and phobic symptoms, and gastrointestinal symptoms.The authors did not perform a factor analysis, because the sample of 82 patients was too small.
Scoring Method
The clinician rates each item from 0 to 3, and higher ratings indicate greater severity. All items carry equal weight.
Time frame: the past 7 days for most items; the weight items refer to the last 2 weeks.Item 9: includes supplementary questions about the time of day when mood is worse and whether mood variation relates to the environment. These do not count toward the 0–3 rating.Score range: the article reports a total range of 0–78, but the printed IDS-C form states "Range: 0–90". These two figures are inconsistent.Not reported: reverse-scored items, subscale scoring and cut-off values.Administration Format
A clinician completes the IDS-C after assessing the patient. It is matched item by item to the self-report IDS-SR, so clinician and patient ratings can be compared.
Applications of the IDS-C
The IDS-C supports several clinical and research uses:
Severity rating: measuring the severity of depressive signs and symptoms at the symptom level.Depression subtypes: capturing endogenous, atypical and anxious features.Research: comparing clinician ratings with self-reports on matched items.Reliability and Validity
In the original study, the IDS-C showed good internal consistency (Cronbach's alpha = 0.88). It also correlated very highly with the Hamilton Rating Scale for Depression (r = 0.92). Moreover, it showed the strongest discrimination between endogenous and nonendogenous depression among the scales compared.
Validation studies:
The Inventory for Depressive Symptomatology (IDS): preliminary findings (1986): study linkThe IDS-C, IDS-SR, QIDS-C and QIDS-SR in public sector patients with mood disorders (2004): study linkLimitations and Considerations
Users should keep these points in mind:
Preliminary evidence: the original study was small (82 outpatients), and the authors call its findings preliminary.Not reported: factor structure, cut-off scores and sensitivity to change.Score range: the printed range (0–90) conflicts with the 0–78 range in the article.Other Versions And Related Questionnaires
The IDS-C belongs to a family of related measures:
The self-report version, the IDS-SRThe 16-item Quick Inventory of Depressive Symptomatology, Clinician Rating (QIDS-C16) and Self-Report (QIDS-SR16); a systematic review and meta-analysis summarizes the QIDS's psychometric propertiesIn addition, the original study compared the IDS-C with these scales:
Hamilton Rating Scale for Depression (HRSD); see the ResRef HAM-D guideBeck Depression Inventory (BDI); see the ResRef BDI-II guideMontgomery-Åsberg ScaleRaskin Depression Scalevon Zerssen ScaleNewcastle ScaleAdditional Resources
The original study on PubMed: linkFor inquiries, the reprint address is Dr. A. John Rush, Affective Disorders Unit and Department of Psychiatry, University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75235, USA.Browse more depression questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
Who completes the IDS-C?A clinician completes the IDS-C after assessing the patient. Its self-report counterpart, the IDS-SR, asks the patient the same items, so the two ratings match item by item.
How many items does the IDS-C have?The IDS-C has 28 items, but only 26 count toward the total. Clinicians rate just one appetite item and one weight item, depending on the direction of change.
What is the IDS-C score range?Each item scores 0 to 3. The article reports a total range of 0 to 78, whereas the printed form states 0 to 90, so users should be aware of this inconsistency.
Does the IDS-C have cut-off scores?No. The original study did not report cut-off scores, a factor structure, or sensitivity to change, and the authors described its findings as preliminary.
A Word from ResRef About the IDS-C
The IDS-C is a clinician-rated, symptom-level measure of depression severity, tested in a small outpatient sample. It showed good internal consistency (α = 0.88), a very high correlation with the HRSD (r = 0.92), and the strongest endogenous versus nonendogenous discrimination of the scales compared in the study. The authors present the findings as preliminary; no factor structure, cut-off scores, or sensitivity-to-change data were reported, and the printed score range (0–90) conflicts with the 0–78 range in the text.
References
Rush, A. J., Giles, D. E., Schlesser, M. A., Fulton, C. L., Weissenburger, J., & Burns, C. (1986). The Inventory for Depressive Symptomatology (IDS): preliminary findings. Psychiatry Research, 18(1), 65–87. https://doi.org/10.1016/0165-1781(86)90060-0Trivedi, M. H., Rush, A. J., Ibrahim, H. M., Carmody, T. J., Biggs, M. M., Suppes, T., Crismon, M. L., Shores-Wilson, K., Toprac, M. G., Dennehy, E. B., Witte, B., & Kashner, T. M. (2004). The Inventory of Depressive Symptomatology, Clinician Rating (IDS-C) and Self-Report (IDS-SR), and the Quick Inventory of Depressive Symptomatology, Clinician Rating (QIDS-C) and Self-Report (QIDS-SR) in public sector patients with mood disorders: a psychometric evaluation. Psychological Medicine, 34(1), 73–82. https://doi.org/10.1017/s0033291703001107Reilly, T. J., MacGillivray, S. A., Reid, I. C., & Cameron, I. M. (2015). Psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology: a systematic review and meta-analysis. Journal of Psychiatric Research, 60, 132–40. https://doi.org/10.1016/j.jpsychires.2014.09.008