Montgomery-Åsberg Depression Rating Scale (MADRS)

Stuart A. Montgomery, Marie Åsberg · 1979

Ten-item clinician rating of depressive symptom severity, sensitive to change, for tagging depressive features in interview speech.

The Montgomery-Åsberg Depression Rating Scale (MADRS) is a ten-item clinician-rated measure of depression severity, designed to be sensitive to change in treatment trials. It emphasizes the core psychological symptoms of depression and deliberately under-weights somatic items, which makes it well suited to reading depressive content out of an interview transcript.

Each item is evidence-mode: highlight the passage in the subject's speech (or the interviewer's observation of the subject) that supports the rating — reported sadness, inner tension, loss of interest, pessimism, suicidal ideation, and so on. One item, Apparent Sadness, is rated from observable dejection rather than self-report; annotate the described presentation. Rate only the subject, never the interviewer's prompts.

Domains (10)

Apparent SadnessASD

Observable dejection conveyed in voice, expression, and posture, distinct from what the subject reports.

Curated skill
Reported SadnessRSD

The subject's own account of low mood, whether or not it shows outwardly.

Curated skill
Inner TensionTEN

Feelings of ill-defined discomfort, edginess, dread, or panic that the subject cannot control.

Curated skill
Reduced SleepSLP

Reduced duration or depth of sleep compared with the subject's own normal pattern.

Curated skill
Reduced AppetiteAPP

Loss of appetite or of the pleasure of eating; needing to force oneself to eat.

Curated skill
Concentration DifficultiesCNC

Difficulty collecting one's thoughts, focusing, or following a train of thought.

Curated skill
LassitudeLAS

Difficulty getting started or slowness initiating and carrying out everyday activities.

Curated skill
Inability to FeelINF

Reduced interest in the surroundings; loss of the capacity to feel pleasure, anger, or emotion.

Curated skill
Pessimistic ThoughtsPES

Thoughts of guilt, inferiority, self-reproach, sinfulness, remorse, or ruin.

Curated skill
Suicidal ThoughtsSUI

Feeling that life is not worth living, wishes for death, or thoughts of or plans for suicide.

Curated skill
Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382-389. doi:10.1192/bjp.134.4.382

Montgomery & Åsberg 1979; freely reproduced (attribute Stuart Montgomery). Cite Montgomery & Åsberg.