Montgomery-Asberg Depression Rating Scale, MADRS Test - the question form
Questions: 10 · 2 minutes
1. Apparent sadness (observed)
Depressed mood, sadness, despair reflected in speech, facial expression, and posture. Rate by depth of mood lowering and inability to be cheered up.
0 – no apparent sadness
1
2 – appears sad or downcast but can be easily cheered up
3
4 – appears sad and unhappy most of the time
5
6 – appears continuously despondent; extremely sad and unhappy
2. Reported sadness
0 – occasional sadness, related to circumstances
1
2 – feels sad or depressed but is easily distracted
3
4 – pervasive feelings of low mood or gloom; mood is still influenced by external events
5
6 – persistent and unvarying feelings of sadness, despair, or misery
3. Inner tension
0 – Calm; only fleeting inner tension
1
2 – Occasional feelings of irritability or inner discomfort
3
4 – Persistent feelings of inner tension or panic, which the patient manages with some difficulty
5
6 – Extreme fear, torment, mental anguish, overwhelming panic
4. Reduced sleep
0 – Sleeps as usual
1
2 – Slight difficulty falling asleep; somewhat shortened, light, or interrupted sleep
3
4 – Sleep is reduced by at least 2 hours
5
6 – Sleep duration is less than 2–3 hours
5. Reduced appetite
0 – Normal or increased appetite
1
2 – Slightly reduced appetite
3
4 – No appetite; food seems tasteless
5
6 – Eats only when urged or pressured
6. Concentration difficulties
0 – No concentration difficulties
1
2 – Occasional difficulty collecting thoughts
3
4 – Difficulty concentrating and sustaining attention, with reduced ability to read or maintain a conversation
5
6 – Unable to read or participate in conversation without considerable effort
7. Lassitude (difficulty initiating and carrying out activities).
0 – No lassitude; any difficulty getting started is doubtful.
1
2 – Difficulty engaging in active pursuits.
3
4 – Difficulty starting routine daily activities; completing them requires additional effort.
5
6 – Complete apathy and inactivity; unable to carry out any purposeful activities without assistance.
8. Inability to feel (apparent sadness). Subjective experience of reduced interest in the surroundings or in activities that normally give pleasure. Reduced ability to respond emotionally to external events or to other people.
0 – Normal interest in surroundings and in people
1
2 – Reduced ability to enjoy things that used to be interesting
3
4 – Loss of interest in surroundings; loss of feelings for friends and acquaintances
5
6 – Emotional paralysis; inability to feel anger, grief, or pleasure; painful absence of feelings for relatives and friends
9. Pessimistic thoughts: Ideas of guilt, worthlessness, self-depreciation, sinfulness, or remorse.
0 – Absent
1
2 – Occasional ideas of failure, self-depreciation, self-criticism, or worthlessness
3
4 – Persistent self-accusation or specific but still rational ideas of guilt or sinfulness; increasing pessimism about the future
5
6 – Delusional ideas of complete ruin, remorse, or unpardonable sin; absurd and unshakable self-accusation
10. Suicidal thoughts: Feeling that life is not worth living, that a natural death would be welcome; suicidal thoughts and preparation for suicide.
0 - Enjoys life or accepts it as it is
1
2 - Tired of life; occasional suicidal thoughts
3
4 - Thoughts that it might be better to die; suicidal thoughts become a frequent preoccupation, and suicide is considered a possible way to solve problems, without specific plans or intent
5
6 - Clear suicidal intent (specific planning to commit suicide at the first opportunity, active preparations for suicide)