A three-factor analytic model of the MADRS in geriatric depression

Int J Geriatr Psychiatry. 2003 Jan;18(1):73-7. doi: 10.1002/gps.776.


Objective: Major depression is a heterogeneous disorder, perhaps comprising several clinical subtypes or subgroups of symptoms. This study examined whether items on the Montgomery-Asberg Depression Rating Scale (MADRS) form distinct symptom subgroups among geriatric depressive patients that might form the basis of new outcome measures for tracking treatment effects.

Method: The study examined a sample of 225 adults age 59 and older diagnosed with major depression. Factor analysis with oblique rotation was used to analyze baseline MADRS item scores.

Results: Three distinct interpretable factors were obtained; all ten items loaded <0.60 on a domain. The first factor, dysphoric apathy/retardation, comprised five items: apparent sadness, reported sadness, lassitude, reduced concentration, and inability to feel. Psychic anxiety, the second factor, included three items: inner tension, pessimistic thoughts, and suicidal thoughts. The third factor, vegetative symptoms, resulted from items involving sleep and appetite.

Conclusions: The study produced three interpretable MADRS factors reflecting geriatric depression dimensions that may be useable to monitor focused treatment outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Affect
  • Aged
  • Anxiety
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Factor Analysis, Statistical
  • Geriatric Assessment / methods
  • Humans
  • Middle Aged
  • Psychiatric Status Rating Scales*
  • Sleep Wake Disorders / etiology
  • Treatment Outcome