Department of Neuroscience, Psychiatry, Uppsala University, Sweden.
J Affect Disord. 2011 Dec;135(1-3):148-53. doi: 10.1016/j.jad.2011.07.005.
Self-rating scales developed for monitoring depression severity are potentially informative and cost effective tools. There is an increasing tendency to use the Montgomery-Åsberg Depression Rating Scale (MADRS) and the self-rating version (MADRS-S) interchangeably.
400 patients with major depressive disorder were included. Concordance between patient and physician ratings was measured by means of repeated MADRS and MADRS-S ratings during a six-month drug trial and one-year follow-up.
Overall scores from patients and physicians show the same trends and both are sensitive to improvements. Our results, however, show only moderate to good agreement between patient and physician ratings. Intraclass coefficients ranged from 0.47 to 0.75 with highest agreement at week 8.
Generalizability is restricted to outpatients in general practice with moderate to severe depression. MADRS-S and MADRS scale definitions are similar but not identical concerning language and are scaled differently, 0-6 vs. 0-3, respectively, which may have influenced the results. The exclusion criteria restricted the range of values for the item Suicidal thoughts/Zest for life, which may have reduced the correlations.
MADRS-S is a suitable tool for following patients' symptoms on a regular basis over time and may also be used to compensate for bias in physicians' ratings in drug trials.
用于监测抑郁严重程度的自评量表是一种潜在的有效且具有成本效益的工具。目前越来越倾向于交替使用蒙哥马利-艾斯伯格抑郁评定量表（MADRS）及其自评版本（MADRS-S）。
纳入了 400 名患有重度抑郁症的患者。在为期六个月的药物试验和一年的随访期间，通过反复进行 MADRS 和 MADRS-S 评分，评估患者和医生评分之间的一致性。
患者和医生的总分显示出相同的趋势，且两者均对改善敏感。然而，我们的结果显示患者和医生的评分之间仅存在中度到高度的一致性。内部一致性系数范围为 0.47 至 0.75，在第 8 周时具有最高的一致性。
本研究的普遍性仅限于一般实践中的门诊中度至重度抑郁症患者。MADRS-S 和 MADRS 量表在语言方面相似但不完全相同，分别为 0-6 分和 0-3 分，这可能影响了结果。排除标准限制了自杀意念/生活乐趣项目的数值范围，这可能降低了相关性。
MADRS-S 是一种随着时间的推移定期跟踪患者症状的合适工具，也可用于补偿药物试验中医生评分的偏差。
