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Montgomery-Asberg Depression Rating Scale
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About Montgomery-Asberg Depression Rating Scale
Scale Name
Montgomery-Asberg Depression Rating Scale
Author Details
Stuart A. Montgomery and Marie Åsberg (1979)
Translation Availability
English
Background/Description
The Montgomery-Åsberg Depression Rating Scale (MADRS), developed by Montgomery and Åsberg (1979), is a 10-item clinician-administered scale designed to measure the severity of depressive symptoms in adults. Published in the British Journal of Psychiatry, the MADRS assesses core symptoms of depression, including mood, feelings of unease, sleep, appetite, concentration, initiative, emotional involvement, pessimism, and suicidal thoughts. It is widely used in clinical settings and research to evaluate depression severity and monitor treatment response, particularly in major depressive disorder (MDD).
Clinicians rate each item based on a semi-structured interview on a 7-point Likert scale (0 = “Normal” to 6 = “Severe”), with total scores ranging from 0–60. Higher scores indicate greater depression severity, with cutoffs typically at: 0–6 (no depression), 7–19 (mild), 20–34 (moderate), and 35–60 (severe). The MADRS was validated with clinical samples (e.g., 44 patients with MDD, mean age ≈ 30–50 years, UK-based), showing sensitivity to change in 80–90% of treatment responders. It correlates with the Hamilton Depression Rating Scale (r ≈ 0.70–0.90) and self-report measures like the Beck Depression Inventory (r ≈ 0.50–0.70). The scale is used in psychiatry, clinical psychology, and clinical trials to assess depression severity and evaluate antidepressant efficacy.
Administration, Scoring and Interpretation
- Obtain the scale from Montgomery and Åsberg (1979) or authorized sources (e.g., British Journal of Psychiatry), ensuring ethical permissions.
- Explain to participants (adults with suspected or diagnosed depression) that the clinician will ask questions about their mood and symptoms, emphasizing confidentiality and voluntary participation.
- Administer the 10-item scale via a semi-structured interview in a clinical setting, rating each symptom based on patient responses and clinical observation over the past week.
- Estimated completion time is 15–20 minutes.
- Ensure a private, supportive environment; provide mental health resources (e.g., crisis hotlines) and adapt for accessibility (e.g., simplified language) if needed.
Reliability and Validity
The MADRS demonstrates strong psychometric properties (Montgomery & Åsberg, 1979). Internal consistency is high (Cronbach’s alpha ≈ 0.85–0.90), based on clinical samples. Inter-rater reliability is robust (r ≈ 0.90–0.95), and test-retest reliability is moderate to high (r ≈ 0.80–0.90 over 1–2 weeks) for stable patients. Convergent validity is supported by correlations with the Hamilton Depression Rating Scale (r ≈ 0.70–0.90) and the Clinical Global Impression scale (r ≈ 0.60–0.80).
Discriminant validity is evidenced by weak correlations with unrelated constructs like general intelligence (r < 0.20). Criterion validity is shown by its ability to differentiate depression severity levels and detect treatment changes. Factorial validity supports a unidimensional structure focused on core depressive symptoms. Pairing with self-report measures like the Patient Health Questionnaire-9 (PHQ-9) or clinician-rated scales like the Hamilton Depression Rating Scale enhances comprehensive assessment.
Available Versions
10-Items
Reference
Montgomery, S. A., & Åsberg, M. A. R. I. E. (1979). A new depression scale designed to be sensitive to change. The British journal of psychiatry, 134(4), 382-389.
Important Link
Scale File:
Frequently Asked Questions
What does the Montgomery-Åsberg Depression Rating Scale measure?
It measures the severity of depressive symptoms, including mood, sleep, and suicidal thoughts.
Who is the target population?
Adults with suspected or diagnosed depression.
How long does it take to administer?
Approximately 15–20 minutes.
Can it inform interventions?
Yes, it assesses depression severity to guide treatment and monitor outcomes.
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