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Some depression rating scales are completed by patients. The Beck Depression Inventory, for example, is a 21-question self-report inventory that covers symptoms such as irritability, fatigue, weight loss, lack of interest in sex, and feelings of guilt, hopelessness or fear of being punished. [11]
The Montgomery–Åsberg Depression Rating Scale (MADRS) is a ten-item [1] diagnostic questionnaire which mental health professionals use to measure the severity of depressive episodes in patients with mood disorders.
The patient is rated by a clinician on 17 to 29 items (depending on version) scored either on a 3-point or 5-point Likert-type scale. For the 17-item version, a score of 0–7 is considered to be normal while a score of 20 or higher (indicating at least moderate severity) is usually required for entry into a clinical trial. [11]
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When the test is scored, a value of 0 to 3 is assigned for each answer and then the total score is compared to a key to determine the depression's severity. The standard cut-off scores were as follows: [7] 0–9: indicates minimal depression; 10–18: indicates mild depression; 19–29: indicates moderate depression; 30–63: indicates severe ...
When using the scale to diagnose depression according to ICD-10, there are the following possibilities: Mild depression: A score of 4 or 5 in two of the first three items. Plus a score of at least 3 on two or three of the last seven items. Moderate depression: A score of 4 or 5 in two or three of the first three items. Plus a score of at least ...
A number of researchers have explored HADS data to establish the cut-off points for caseness of anxiety or depression. Bjelland et al (2002) [3] through a literature review of a large number of studies identified a cut-off point of 8/21 for anxiety or depression. For anxiety (HADS-A) this gave a specificity of 0.78 and a sensitivity of 0.9.
The QLDS’ responsiveness was analysed in a general practice population of 540 patients with major depression. Over a 6-month period, substantial progress in the level of depression was seen. [3] 8 weeks into treatment the mean QLDS score rose by 68%, with patients who continued treatment for the full 6-months recording an increase of 78%.