Differentiating moderate and severe depression using the Montgomery-Asberg depression rating scale (MADRS)

Müller, M

doi:10.1016/s0165-0327(02)00120-9

Cited by 282Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionPsychological Testing and Assessment

Differentiating moderate and severe depression using the Montgomery-Asberg depression rating scale (MADRS)

Müller, M·2003·Journal of Affective Disorders

DOI 10.1016/s0165-0327(02)00120-9

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Abstract

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).Method 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%).Limitations 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.

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The mean MADRS-S total score at baseline was 36.8 (SD 8.9), indicating high severity.
“The mean (SD) MADRS-S total score at baseline was 36.8 (8.9), indicating high severity (36).”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [36]

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Moderate and severe depression
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Evaluation of MADRS severity thresholds in patients with bipolar depression
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A comparison of the ‘Hamilton Rating Scale for Depression’ and the ‘Montgomery-Asberg Depression rating Scale’
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Authors: Müller, M.
Affiliations: Johannes Gutenberg University Mainz (DE)
Corresponding author: Müller, M
ORCID: Müller, M
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2003-12
Volume: 77
Issue: 3
Pages: 255-260
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/s0165-0327(02)00120-9
OpenAlex: W1979534890
Cited by: 282
References: 22
Citations by year: 2026: 18 · 2025: 26 · 2024: 30 · 2023: 23 · 2022: 15 · 2021: 20 · 2020: 11 · 2019: 12 · 2018: 6 · 2017: 6 · 2016: 7 · 2015: 14 · 2014: 12 · 2013: 9 · 2012: 16
FWCI: 3.36
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: Montgomery-Asberg Depression Rating Scale, depression severity, moderate depression, severe depression, cut-off values, Hamilton Depression Rating Scale, Clinical Global Impression Scale, major depressive disorder, sensitivity and specificity
MeSH terms: Adult, Aged, Depressive Disorder, Diagnosis, Differential, Female, Humans, Male, Mental Status Schedule, Middle Aged, Reference Values, Severity of Illness Index, Diagnostic and Statistical Manual of Mental Disorders

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Differentiating moderate and severe depression using the Montgomery-Asberg depression rating scale (MADRS)

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