title: Diagnostic Validity and Factor Analysis of Montgomery-Asberg Depression Rating Scale in Parkinson Disease Population.
abstract: BACKGROUND
  The Montgomery-Asberg Depression Rating Scale (MADRS) is commonly used to assess major depression in Parkinson disease (PD), but studies on its utility are few. This study examines the validity and factor structure of MADRS in population with PD.
  
  
  METHODS
  In 104 patients with idiopathic PD, major depression was diagnosed by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) criteria, and all patients were rated by MADRS.
  
  
  RESULTS
  The MADRS showed good concurrent validity with DSM-IV-TR criteria. The diagnostic cutoff was established as 16/17 (sensitivity 97.43, specificity 100%, positive predictive value 100%, and negative predictive value 98.48%). Factor analysis identified 3 factors, accounting for 76% of total variance: "sadness-anhedonia" comprising apparent sadness, reported sadness, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal ideas; "anxiety" with reduced sleep and inner tension; and "vegetative symptoms" with reduced appetite.
  
  
  CONCLUSIONS
  The MADRS has diagnostic utility in major depression in PD. The 3-factor structure of MADRS may help to understand the different dimensions of major depression and identify distinct symptom subgroups in this population.
authors.affiliation: North Western Mental Health, Melbourne Health, Victoria, Australia tharini.ketharanathan@mh.org.au.
authors.forename: Tharini
authors.initials: T
authors.lastname: Ketharanathan
authors.affiliation: Department of Psychological Medicine, University of Colombo, Colombo, Sri Lanka.
authors.forename: Raveen
authors.initials: R
authors.lastname: Hanwella
authors.affiliation: Top End Mental Health Service, Royal Darwin Hospital, Darwin, Australia.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Weerasundera
authors.affiliation: Department of Psychological Medicine, University of Colombo, Colombo, Sri Lanka.
authors.forename: Varuni Asanka
authors.initials: VA
authors.lastname: de Silva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059445:Anhedonia; D001007:Anxiety / Q000150:complications / Q000175:diagnosis; D001008:Anxiety Disorders; D003863:Depression / Q000145:classification / Q000150:complications* / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000145:classification / Q000150:complications* / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Parkinson disease; depression; geriatric psychiatry; mental health