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Comparative Study
, 9, 26

The Self-Reported Montgomery-Asberg Depression Rating Scale Is a Useful Evaluative Tool in Major Depressive Disorder

Comparative Study

The Self-Reported Montgomery-Asberg Depression Rating Scale Is a Useful Evaluative Tool in Major Depressive Disorder

Bruno Fantino et al. BMC Psychiatry.


Background: The use of Patient-reported Outcomes (PROs) as secondary endpoints in the development of new antidepressants has grown in recent years. The objective of this study was to assess the psychometric properties of the 9-item, patient-administered version of the Montgomery-Asberg Depression Rating Scale (MADRS-S).

Methods: Data from a multicentre, double-blind, 8-week, randomised controlled trial of 278 outpatients diagnosed with Major Depressive Disorder were used to evaluate the validity, reliability and sensitivity to change of the MADRS-S using psychometric methods. A Receiver Operating Characteristic (ROC) curve was plotted to identify the most appropriate threshold to define perceived remission.

Results: No missing values were found at the item level, indicating good acceptability of the scale. The construct validity was satisfactory: all items contributed to a common underlying concept, as expected. The correlation between MADRS-S and physicians' MADRS was moderate (r = 0.54, p < 0.001) indicating that MADRS-S is complementary rather than redundant to the MADRS. Cronbach's alpha was 0.84, and the stability over time of the scale, estimated on a sub-sample of patients whose health status did not change during the first week of the study, was good (intraclass correlation coefficient of 0.78). MADRS-S sensitivity to change was shown. Using a threshold value of 5, the definition of "perceived remission" reached a sensitivity of 82% and a specificity of 75%.

Conclusion: Taking account of patient's perceptions of the severity of their own symptoms along with the psychometric properties of the MADRS-S enable its use for evaluative purposes in the development of new antidepressant drugs.


Figure 1
Figure 1
Receiver Operating Characteristic Curve for Perceived Remission. CO: cut-off value for MADRS-S score.
Figure 2
Figure 2
Perceived Response and Perceived Remission at Week 8.

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