Montgomery–Åsberg Depression Rating Scale Explained

Montgomery–Åsberg Depression Rating Scale
Purpose:	severity of depression

The Montgomery–Åsberg Depression Rating Scale (MADRS) is a ten-item^[1] diagnostic questionnaire which mental health professionals use to measure the severity of depressive episodes in patients with mood disorders. It was designed in 1979 by British and Swedish researchers (Stuart Montgomery and Marie Åsberg) as an adjunct to the Hamilton Rating Scale for Depression (HAMD) which would be more sensitive to the changes brought on by antidepressants and other forms of treatment than the Hamilton Scale was.^[2] There is, however, a high degree of statistical correlation between scores on the two measures.^[3]

Interpretation

The questionnaire includes questions on ten symptoms:

• Apparent sadness
• Reported sadness
• Inner tension
• Reduced sleep
• Reduced appetite
• Concentration difficulties
• Lassitude
• Inability to feel
• Pessimistic thoughts
• Suicidal thoughts

Each item yields a score of 0 to 6; the overall score thus ranges from 0 to 60.^[4] Higher MADRS score indicates more severe depression.Usual cutoff points are:

• 0 to 6: normal^[5] /symptom absent^[4]
• 7 to 19: mild depression^{[4] [5]}
• 20 to 34: moderate depression^[5]
• 35 to 60: severe depression.^[5]

MADRS-S

A self-rating version of this scale (MADRS-S) is often used in clinical practice and correlates reasonably well with expert ratings.^[6] The MADRS-S instrument has nine questions, with an overall score ranging from 0 to 54 points.^[7]

See also

• Comprehensive Psychopathological Rating Scale
• Diagnostic classification and rating scales used in psychiatry

External links

• Automatically scored digital version of the MADRS
• https://imrg.irFull version of the Montgomery–Åsberg Depression Rating Scale
• Side-by-side comparison of the MADRS and HAMD

Notes and References

1. Williams . J. B. W. . Kobak . K. A. . 10.1192/bjp.bp.106.032532 . Development and reliability of a structured interview guide for the Montgomery-Asberg Depression Rating Scale (SIGMA) . The British Journal of Psychiatry . 192 . 1 . 52–58 . 2008 . 18174510. free .
2. Montgomery SA, Asberg M. April 1979 . A new depression scale designed to be sensitive to change . British Journal of Psychiatry . 134. 382–89 . 444788 . 10.1192/bjp.134.4.382 . 4. 22246215 .
3. https://web.archive.org/web/20071010055043/http://ajgponline.org/cgi/content/abstract/15/10/899 Relationship Between the Hamilton Depression Rating Scale and the Montgomery–Åsberg Depression Rating Scale in Depressed Elderly: A Meta-analysis
4. http://instruct.uwo.ca/kinesiology/9641/Assessments/Psychological/MADRS.html Test: Montgomery-Åsberg Depression Rating Scale (MADRS)
5. Herrmann . N. . Black . S. E. . Lawrence . J. . Szekely . C. . Szalai . J. P. . The Sunnybrook Stroke Study : A Prospective Study of Depressive Symptoms and Functional Outcome . 10.1161/01.STR.29.3.618 . Stroke . 29 . 3 . 618–624 . 1998 . 9506602. free .
6. Cunningham . JL . etal . 2011 . Agreement between physicians' and patients' ratings on the Montgomery Åsberg Depression Rating Scale . Journal of Affective Disorders . 135 . 1–3. 148–53 . 21856017 . 10.1016/j.jad.2011.07.005.
7. Svanborg . P . Åsberg . M . 2001 . A comparison between the Beck Depression Inventory (BDI) and the self-rating version of the Montgomery Åsberg Depression Rating Scale (MADRS) . Journal of Affective Disorders . 64 . 2–3. 203–216 . 10.1016/S0165-0327(00)00242-1. 11313087 .