MADRS: Montgomery-Åsberg Depression Rating Scale

Overview

The MADRS is a 10-item clinician rating with item values from 0 to 6 and a 0-to-60 total. Survey Doctor's digital form has wording errors and duplicate odd/even anchors in its first nine items. Its total and any displayed band are therefore not clinically verified. Use an authorized form instead.

The stored values can be added. The defective response key prevents a verified clinical result.

Introduction

Montgomery and Åsberg developed the scale to follow change in depression symptoms. A trained rater combines interview information and observation, then selects a defined even-numbered anchor or a true intermediate rating.

This digital form follows a secondary transcription rather than the primary wording. Comparison with the primary wording shows errors in several stems and anchors. One changes difficulty into initiative, which reverses the meaning of that response.

Exact wording matters.

The larger defect affects items 1 through 9. Their labels at values 1, 3, and 5 repeat the label at the next even value. Identical visible text can therefore store 1 or 2, 3 or 4, or 5 or 6.

The ambiguity is consequential.

Who should use the MADRS?

The MADRS is for trained clinicians and research raters. It is not a self-report questionnaire. Survey Doctor does not offer it through the patient take-survey route, and direct patient submissions are rejected.

An authorized protocol should specify the form, interview method, assessment interval, and rater training. Record those details with each rating.

The method matters.

Score interpretation

The source MADRS has ten ratings from 0 to 6. Adding them gives a total from 0 to 60.

Valid ratings come first.

A valid sum depends on valid ratings. Reaching the expected range does not repair mistranscribed anchors or show which value a duplicated label was meant to represent.

Arithmetic is not enough.

The digital definition also contains legacy score bands. Even if a result page displays one, do not treat it as a verified interpretation of this form. Published MADRS conventions differ by setting and purpose.

Bands cannot fix anchors.

The total does not establish diagnosis, remission, treatment response, or level of care on its own.

Item 10 and safety

Item 10 concerns thoughts about death and suicide. In native item-level records, any value above 0 is marked for direct safety review. The total cannot show whether that item was endorsed.

A total-only record is especially limited. Some historical imported MADRS scores came from an incompatible 0/2/4/6 form without item answers. Survey Doctor keeps those records outside native scoring and interpretation, and their missing safety-item response cannot be reconstructed.

The missing item matters.

If item 10 is above 0, complete a direct suicide-risk assessment under the organization's safety protocol. Do not wait for the total or a severity label.

If you need help now. In the US, Call 988 or text 988. Call 911 if you are in immediate danger. Outside the US, contact your local emergency number or find support in your country.

What the questions measure

The ten domains cover observed and reported mood, tension, sleep, appetite, concentration, energy, ability to feel, pessimism, and suicidal thoughts. A trained rater considers the interview and observation together.

Clinical applications

Do not use a total produced by this digital form for clinical interpretation. If an authorized MADRS was completed elsewhere, keep its edition, interval, item ratings, rater method, and date together.

Keep the original context.

The QIDS-SR16 and PHQ-9 are questionnaires people answer themselves. They serve different purposes and their scores cannot be converted to MADRS totals.

When to seek help

The total does not define an emergency or treatment plan. Respond to symptoms, functioning, and current safety. Follow the organization's suicide-risk assessment protocol for any item 10 value above 0.

Evidence and validation

Montgomery and Åsberg developed the scale to measure change in depression symptoms. Later studies examined cutoff conventions in specific settings. Those findings depend on a valid form and trained, consistent administration.

Form quality is essential.

For a patient-facing explanation of the same boundary, read what your MADRS score means.