The self-reported Montgomery-Asberg Depression Rating Scale is a useful evaluative tool in Major Depressive Disorder

BMC Psychiatry. 2009 May 27;9:26. doi: 10.1186/1471-244X-9-26.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care
  • Antidepressive Agents / chemical synthesis
  • Antidepressive Agents / therapeutic use
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / psychology
  • Drug Discovery / methods
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics
  • ROC Curve
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antidepressive Agents