title: The Montgomery Asberg and the Hamilton ratings of depression: a comparison of measures.
abstract: The 17-item Hamilton Rating Scale for Depression (HRSD(17)) and the Montgomery Asberg Depression Rating Scale (MADRS) are two widely used clinician-rated symptom scales. A 6-item version of the HRSD (HRSD(6)) was created by Bech to address the psychometric limitations of the HRSD(17). The psychometric properties of these measures were compared using classical test theory (CTT) and item response theory (IRT) methods. IRT methods were used to equate total scores on any two scales. Data from two distinctly different outpatient studies of nonpsychotic major depression: a 12-month study of highly treatment-resistant patients (n=233) and an 8-week acute phase drug treatment trial (n=985) were used for robustness of results. MADRS and HRSD(6) items generally contributed more to the measurement of depression than HRSD(17) items as shown by higher item-total correlations and higher IRT slope parameters. The MADRS and HRSD(6) were unifactorial while the HRSD(17) contained 2 factors. The MADRS showed about twice the precision in estimating depression as either the HRSD(17) or HRSD(6) for average severity of depression. An HRSD(17) of 7 corresponded to an 8 or 9 on the MADRS and 4 on the HRSD(6). The MADRS would be superior to the HRSD(17) in the conduct of clinical trials.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas, TX 75390-9086, United States. Thomas.Carmody@UTSouthwestern.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Carmody
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
authors.forename: Ira
authors.initials: I
authors.lastname: Bernstein
authors.forename: Diane
authors.initials: D
authors.lastname: Warden
authors.forename: Stephen
authors.initials: S
authors.lastname: Brannan
authors.forename: Daniel
authors.initials: D
authors.lastname: Burnham
authors.forename: Ada
authors.initials: A
authors.lastname: Woo
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D014894:Weights and Measures
chemical_list: D000928:Antidepressive Agents