SCNP Contributions: rating scales.

Abstract

At the constitutional meeting of SCNP in February 1960 it was discussed that rating scales might be one of the ways to standardize trials in the Nordic countries, i.e. by focussing on the “target symptoms†for pharmacotherapeutic drug treatment in psychiatry.

In 1969, the UKU (Udvalg for kliniske undersøgelser) was established as a standing committee of SCNP with one member from each of the Nordic countries. The industry was represented as well by one member and Kjell Elgen was the long-term member. Odd Lingjærde was the first UKU chairman and he organised the only randomized clinical trial initiated by the UKU: The effect of lithium in combination with tricyclic antidepressants in depression (1). The Hamilton Depression Scale was used as an outcome measure and lithium was found superior to placebo (a response rate of 79% versus 58% in combination with TCA).

The Swedish National Board of Health and Welfare asked UKU to develop a side effect rating scale. This scale, the UKU Side Effect Scale for Psychoactive Drugs, was tested in a large Nordic study in neuroleptic-treated patients. It was concluded that the individual items had to be analysed separately because the total score was not a sufficient statistic (2).

Another major UKU publication was the collection of internationally accepted rating scales, both for the assessment of diagnoses and for severity of mental disorders and for measure outcome of psychopharmacological treatment. This UKU rating scale book was published in the “internordic" language, i.e. Norwegian (3a, 3b), and in English (4).

A patient-administrated version of the UKU side effect scale including consumer satisfaction with care was hereafter published (5). Approximately 10 years ago, the SCNP decided to close down all standing committees, including the UKU.

In conclusion, throughout the history of SCNP, the UKU has made a major approach to complete the pharmacopsychological triangle defined by the assessment of wanted drug effects, unwanted drug effects, and the patient’s own satisfaction with treatment.

This collection of highly relevant clinical rating scales, selected by the UKU during the thirty years of its existence, is the work of a small number of outstanding psychiatrists:

From Norway: Odd Lingjærde and Ulrik Malt, from Sweden: Sven Jonas Dencker and Ulf Malm, from Finland: Ulf-Göran Ahlfors, and from Denmark: Henrik Lublin and Per Bech. In the UKU the industry was always represented by one member, during the last period Thomas Lewander replaced Kjell Elgen.

 

References:

1)

Lingjærde O et al. Acta Psychiatr Scand  1974;50:233-242

2)

Lingjærde O et al. Acta Psychiatr Scand  1987;76 (suppl 334)

3a)

Lingjærde O et al. Acta Psychiatr Scand  1989;43 (suppl 19)

3b)

Malt UF et al. Nordic J Psychiatr 1990;44:issue2

4)

Bech P et al. Acta Psychiatr Scand 1993;87 (suppl 372)

5)

Ahlfors UG et al . Nordic J Psychiatr 2001;55 (suppl 44)