Montgomery-Asberg Depression Rating Scale (MADRS)
Stratifies severity of depressive episodes in adults.
INSTRUCTIONS
Use in adults only (≥18 years). Rate based on clinical interview with the patient. Use clinical judgment to determine whether the rating lies on the defined scale steps (0, 2, 4, 6 points) or between them (1, 3, 5 points, denoted as "(Worsening symptoms)").
When to Use
Pearls/Pitfalls
Why Use
Rate each of the following based on clinical interview with the patient:
No sadness
0(Worsening symptoms)
+1Looks dispirited but brightens up without difficulty
+2(Worsening symptoms)
+3Appears sad and unhappy most of the time
+4(Worsening symptoms)
+5Looks miserable all the time; extremely despondent
+6Occasional sadness in keeping with circumstances
0(Worsening symptoms)
+1Sad or low but brightens up without difficulty
+2(Worsening symptoms)
+3Pervasive feelings of sadness or gloominess; mood still influenced by external circumstances
+4(Worsening symptoms)
+5Continuous or unvarying sadness, misery, or despondency
+6Placid; only fleeting inner tension
0(Worsening symptoms)
+1Occasional feelings of edginess and ill-defined discomfort
+2(Worsening symptoms)
+3Continuous feelings of inner tension or intermittent panic which the patient can only master with some difficulty
+4(Worsening symptoms)
+5Unrelenting dread or anguish; overwhelming panic
+6Sleeps as normal
0(Worsening symptoms)
+1Slight difficulty dropping off to sleep, or slightly reduced, light, or fitful sleep
+2(Worsening symptoms)
+3Sleep reduced or broken by at least two hours
+4(Worsening symptoms)
+5<2-3 hours of sleep
+6Normal or increased appetite
0(Worsening symptoms)
+1Slightly reduced appetite
+2(Worsening symptoms)
+3No appetite; food is tasteless
+4(Worsening symptoms)
+5Needs persuasion to eat
+6No difficulties in concentrating
0(Worsening symptoms)
+1Occasional difficulties in collecting one’s thoughts
+2(Worsening symptoms)
+3Difficulties in concentrating and sustaining thought which reduces ability to read or hold a conversation
+4(Worsening symptoms)
+5Unable to read or converse without great initiative
+6Hardly any difficulty getting started in daily activities; no sluggishness
0(Worsening symptoms)
+1Difficulty in starting activities
+2(Worsening symptoms)
+3Difficulty starting simple routine activities, which are carried out with effort
+4(Worsening symptoms)
+5Complete lassitude; unable to do anything without help
+6Normal interest in surroundings/other people
0(Worsening symptoms)
+1Reduced ability to enjoy usual interests
+2(Worsening symptoms)
+3Loss of interest in surroundings; loss of feelings for friends/acquaintances
+4(Worsening symptoms)
+5Emotionally paralyzed, unable to feel anger, grief, or pleasure; complete failure to feel for close relatives and friends
+6No pessimistic thoughts
0(Worsening symptoms)
+1Fluctuating ideas of failure, self reproach, or self depreciation
+2(Worsening symptoms)
+3Persistent self accusations or definite but still rational ideas of guilt; increasingly pessimistic about the future
+4(Worsening symptoms)
+5Delusions of ruin, remorse, or irredeemable sin; absurd and unshakable self accusations
+6Enjoys life
0(Worsening symptoms)
+1Weary of life; only fleeting suicidal thoughts
+2(Worsening symptoms)
+3Feels better off dead; suicidal thoughts common and considered as possible solution but no specific plans/intention
+4(Worsening symptoms)
+5Explicit plans for suicide; active preparations
+6Result:
Please fill out required fields.