The Oxford Depression Questionnaire (ODQ)

The Oxford Depression Questionnaire (ODQ) is a patient-centred, self-report measure of emotional symptoms present in patients treated with antidepressants.

Background

Some patients with major depression report a restricted range of emotions that may appear to arise as a side-effect of treatment with antidepressants. It is uncertain whether this phenomenon, sometimes called emotional blunting, represents residual symptoms of depression or side-effects of antidepressant treatment. The Oxford Depression Questionnaire (ODQ) is a patient-centred, self-report measure of emotional symptoms present in patients treated with antidepressants.

The key characteristics and benefits of the ODQ (based on results acquired during development) are:

Acceptability

Completion of the questionnaire by patients was extremely high with 96% completing the instrument on 3 separate occasions (weeks 0, 1 and 4)

Validity

The ODQ has high construct validity with four dimensions (reduction in positive emotions; general reduction in emotions; not caring; and emotional detachment) being represented in the ODQ. In addition, items in the ODQ demonstrate close relationships to contents of other scores measuring emotional blunting.

Sensitivity to change

When compared to a “gold standard” question (relating to the participant’s experience of emotional side-effects) the ODQ appears to be sensitive to change.

Reliability

The ODQ has high reliability, both in terms of internal reliability (items within each construct were highly correlated) and test-retest reliability.

The PRO

The ODQ is a 26-item patient self-complete measure, spread over 3 sections and covering 4 dimensions (derived from qualitative research) of

  • not caring (NC),
  • emotional detachment (ED),
  • positive reduction (PR)
  • general reduction (GR)

The 3 sections of the ODQ are:

Section 1:

12 items, three items from each of the 4 dimensions (NC, ED, PR and GR). Recall period is the last week.

Section 2:

8 items, 2 from each of the four dimensions, comparing respondents experiences during the previous week with in comparison to their experiences before they developed their illness / problem.

Section 3:

6 items, is for completion by those respondents currently prescribed antidepressants. This section addresses the extent to which participants attribute their emotional difficulties to their antidepressant, and the extent to which they would therefore be considered by participants to be “emotional side-effects”. It also addresses the possible impact of emotional side-effects on antidepressant adherence.

Response options are based on 5 point likert scale with a score applied to each response. Results can be presented on a dimension basis or summed to give an overall ODQ score. If required an additional dimension “Antidepressant as cause (AC)” can also be scored. Full details of scoring and handling missing data are available with the licence to use the ODQ.

The ODQ can be used as:

  • a clinical tool, to facilitate the identification of patients with the syndrome of emotional blunting,

  • it can also be used in research studies, to advance understanding of the nature, causes and particularly the treatment of this phenomenon.

Example studies:

  • The ODQ can be used as a clinical tool, to facilitate the identification of patients with the syndrome of emotional blunting,
  • The ODQ cab be also used in research studies, to advance understanding of the nature, causes and particularly the treatment of this phenomenon.

Development:

The ODQ was created as existing instruments, that claim to measure emotional blunting, lacked either careful design or validation. The ODQ was designed, built, tested, and validated using methods consistent with best-practice in the development of such instruments. The draft questionnaire was developed from patient-derived qualitative data, refined using cognitive interviewing, and administered on three occasions to patients taking antidepressants. Statistical methods including factor analysis were used to reduce the size of the draft questionnaire, and to assess the performance of the resulting ODQ. Further details on the design, testing and validation of the ODQ are available on request. The ODQ was developed within the Department of Psychiatry at the University of Oxford by Professor Guy Goodwin and Dr Jonathan Price. A publication on the development, validity, reliability and sensitivity of the ODQ is in press.

 

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