A three-factor model of the MADRS in major depressive disorder

Abstract

Major Depressive Disorder (MDD) may be composed of some symptom clusters with distinct neurochemical disturbances, suggesting the importance of the factor analysis of depressive symptoms; however, the results of previous studies using the Montgomery-Asberg Depression Rating Scale (MADRS) have been inconsistent. In the present study, factor analysis of the MADRS was performed in 132 Japanese patients (range 23-74 years, mean 47.6 years) with MDD without any psychiatric comorbidity. The principal component analysis with Varimax rotation identified three factors, accounting for 61% of the total variance: The first factor, labeled dysphoria, included pessimistic thoughts, suicidal thoughts, and reported sadness; the second factor, labeled retardation, included lassitude, inability to feel, apparent sadness, and concentration difficulties; and the third factor, labeled vegetative symptoms, included reduced sleep, reduced appetite, and inner tension. The score of the vegetative factor showed a significant positive correlation with age and was significantly higher in females than in males. This study suggests that the symptoms of MDD, as assessed by the MADRS, cluster into three factors (dysphoria, retardation, and vegetative symptoms).

The reliability of three depression rating scales in a general population of Dutch older persons

“…The internal consistency of the MADRS (a ¼ 0.68) was acceptable, indicating that the items of the MADRS reflect depressive symptoms in a healthy study population reasonably well. Three other studies on the internal consistency of the MADRS showed inconsistent results in different study populations (Table 4) (Hammond, 1998;Suzuki et al, 2005;Smalbrugge et al, 2008). The Cronbach's alpha of 0.41 for the GDS-15 in our study is low, which might be attributed to the strongly skewed distribution and the small variance, probably due to the yes/no answer format.…”

A Reexamination of Nonpsychiatric Medication Adherence in Individuals With Bipolar Disorder and Medical Comorbidities

“…Given the multidimensional nature of depression, several studies examined the factor analytical structure of the MADRS. The most robust model, accounting for 61% of the total variance, was that of a three factor solution (Suzuki et al, 2005). The three factors include Dysphoria, Retardation, and Vegetative Symptoms (see Table 2).…”

“…MADRS factor structure based on Suzuki’s three-factor model (Suzuki et al, 2005). BPRS factor structure based on a five-factor model (Shafer, 2005).…”

Mixed-methods analysis of internalized stigma correlates in poorly adherent individuals with bipolar disorder

“…The MADRS has a three-factor structure: Dysphoria, Retardation, and Vegetative Symptoms. MADRS scores can be categorized as follows: 0–7 normal, 8–15 mild depression, 16–25 moderate, 26–30 severe, and 31+ very severe [31]. Total YMRS scores >12 denote BD mania [29].…”