title: Moderate and severe depression. Gradations for the Montgomery-Asberg Depression Rating Scale.
abstract: BACKGROUND
  Despite its importance, no distinction between moderate and severe depression using the Montgomery-Asberg Depression Rating Scale (MADRS) based on a direct comparison with the Hamilton Depression Rating Scale (HAMD-17) is available.
  
  
  METHODS
  HAMD-17 and MADRS ratings from N=40 at least moderately depressed inpatients with major depression (DSM-III-R) were analyzed. Linear and non-parametric correlations were computed and a MADRS cut-off score for severe depression using an HAMD-17 score of at least 28 points as reference was estimated.
  
  
  RESULTS
  HAMD-17 and MADRS mean scores were 24.6+/-4.3 and 32.6+/-5.0 points, respectively. Linear correlation of both scores was r=0.70 (P<0.0005). A MADRS cut-off score of at least 35 points was estimated to separate 'moderate' from 'severe' depression corresponding to a HAMD-17 cut-off of 28 points with sufficient sensitivity and specificity.
  
  
  CONCLUSIONS
  The sample size was limited and no observer ratings directly assessing the severity of depression were used.
  
  
  CONCLUSIONS
  The preliminary findings are in line with previous findings and suggest a cut-off score of 35 points to separate moderate from severe depression with the MADRS accepting an HAMD-17 score of >/=28 point as reference. Further studies on this issue are warranted.
authors.affiliation: Department of Psychiatry, University of Mainz, Untere Zahlbacher Strasse 8, D-55131, Mainz, Germany. mjm@mail.psychiatrie.klinik.uni-mainz.de
authors.forename: M J
authors.initials: MJ
authors.lastname: Müller
authors.forename: A
authors.initials: A
authors.lastname: Szegedi
authors.forename: H
authors.initials: H
authors.lastname: Wetzel
authors.forename: O
authors.initials: O
authors.lastname: Benkert
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index