title: Agreement between physicians' and patients' ratings on the Montgomery-Åsberg Depression Rating Scale.
abstract: BACKGROUND
  Self-rating scales developed for monitoring depression severity are potentially informative and cost effective tools. There is an increasing tendency to use the Montgomery-Åsberg Depression Rating Scale (MADRS) and the self-rating version (MADRS-S) interchangeably.
  
  
  METHODS
  400 patients with major depressive disorder were included. Concordance between patient and physician ratings was measured by means of repeated MADRS and MADRS-S ratings during a six-month drug trial and one-year follow-up.
  
  
  RESULTS
  Overall scores from patients and physicians show the same trends and both are sensitive to improvements. Our results, however, show only moderate to good agreement between patient and physician ratings. Intraclass coefficients ranged from 0.47 to 0.75 with highest agreement at week 8.
  
  
  CONCLUSIONS
  Generalizability is restricted to outpatients in general practice with moderate to severe depression. MADRS-S and MADRS scale definitions are similar but not identical concerning language and are scaled differently, 0-6 vs. 0-3, respectively, which may have influenced the results. The exclusion criteria restricted the range of values for the item Suicidal thoughts/Zest for life, which may have reduced the correlations.
  
  
  CONCLUSIONS
  MADRS-S is a suitable tool for following patients' symptoms on a regular basis over time and may also be used to compensate for bias in physicians' ratings in drug trials.
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University, Sweden. Janet.cunningham@neuro.uu.se
authors.forename: Janet L
authors.initials: JL
authors.lastname: Cunningham
authors.forename: Lisa
authors.initials: L
authors.lastname: Wernroth
authors.forename: Lars
authors.initials: L
authors.lastname: von Knorring
authors.forename: Lars
authors.initials: L
authors.lastname: Berglund
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
mesh_terms: D000328:Adult; D003863:Depression; D003866:Depressive Disorder / Q000175:diagnosis; D003865:Major Depressive Disorder / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012647:Self-Assessment; D012720:Severity of Illness Index