The Montgomery Äsberg and the Hamilton ratings of depression: A comparison of measures

Abstract

The 17-item Hamilton Rating Scale for Depression (HRSD 17 ) and the Montgomery Äsberg Depression Rating Scale (MADRS) are two widely used clinicianrated symptom scales. A 6-item version of the HRSD (HRSD 6 ) was created by Bech to address the psychometric limitations of the HRSD 17 . The psychometric properties of these measures were compared using classical test theory (CTT) and item response theory (IRT) methods. IRT methods were used to equate total scores on any two scales. Data from two distinctly different outpatient studies of nonpsychotic major depression: a 12-month study of highly treatment-resistant patients (n=233) and an 8-week acute phase drug treatment trial (n=985) were used for robustness of results.MADRS and HRSD 6 items generally contributed more to the measurement of depression than HRSD 17 items as shown by higher item-total correlations and higher IRT slope parameters. The MADRS and HRSD 6 were unifactorial while the HRSD 17 contained 2 factors. The MADRS showed about twice the precision in estimating depression as either the HRSD 17 or HRSD 6 for average severity of depression. An HRSD 17 of 7 corresponded to an 8 or 9 on the MADRS and 4 on the HRSD 6 .The MADRS would be superior to the HRSD 17 in the conduct of clinical trials.

Depressive symptoms and healthcare utilization in patients with noncardiac chest pain compared to patients with ischemic heart disease

“…30,32 The MADRS is a valid and reliable unifactorial depression rating scale 30,33,34 and has high internal consistency with Cronbach's alpha values of 0.85-0.92 in patients with major depressive disorder and stroke. 35,36 In our study the Cronbach's alpha coefficient was 0.86. In comparison to other measurements the MADRS has the strongest association to the clinician's assessment.…”

The Quick Inventory of Depressive Symptomatology-Self-report: a psychometric evaluation in patients with asthma and major depressive disorder

“…Exit scores are typically preferable to baseline scores because the study enrollment criteria may result in a reduction in the variability of the baseline scores and may have been used in other studies on the psychometric properties of depression measures. [35][36][37] This effect may be magnified in the present study because a minimum baseline score on the HRSD 17 was part of the inclusion criteria.…”

Trajectories of change in depression severity during treatment with antidepressants

“…Remission ' was defined by a consensus board as a score of f7 on HAMD 17 or f8 on BDI (Frank et al 1991). There has been some debate over the thresholds for remission on MADRS : a threshold of f11 was first suggested, but later investigations found that a MADRS total score of 10 or 9 better corresponds to the HAMD 17 score of 7 (Zimmerman et al 2004 ;Carmody et al 2006 ;Uher et al 2008). Therefore, we define ' remission ' as reaching a score of f7 on HAMD 17 , f10 on MADRS and f8 on BDI, based on the last valid observation over the 12-weeks, i.e.…”