Differentiating moderate and severe depression using the Montgomery-Asberg depression rating scale (MADRS).
BACKGROUND
MADRS cut-off scores for moderate and severe depression were estimated in relation to the Hamilton Depression Rating Scale (HAMD(17)) and the Clinical Global Impressions Scale (CGI).


METHODS
HAMD(17), MADRS, and CGI ratings from patients with major depression (DSM-IV) were analyzed (N=85). Receiver operating characteristics (ROC) curves were applied.


RESULTS
Mean age was 51.4+/-14.5 years, 69% were female. Mean MADRS scores were 23.4+/-13.2, HAMD(17), MADRS, and CGI scores were highly correlated (r>0.85; P<0.0001). Best separation between moderate and severe depression according to CGI criteria was achieved with a MADRS score of 31 (sensitivity 93.5%, specificity 83.3%).


CONCLUSIONS
Studies to validate severity gradations including DSM-IV or ICD-10 diagnostic severity categories are recommended.


CONCLUSIONS
Empirically based MADRS cut-off scores to separate moderate from severe depression on the basis of HAMD(17) and CGI severity ratings in patients with major depression were yielded.
Müller
Matthias J
MJ
Department of Psychiatry, University of Mainz, Untere Zahlbacher Strasse 8, D-55131, Mainz, Germany. mjm@mail.psychiatrie.klinik.uni-mainz.de
Himmerich
Hubertus
H
Kienzle
Barbara
B
Szegedi
Armin
A
D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D012016:Reference Values; D012720:Severity of Illness Index