Published in

BioMed Central, BMC Psychiatry, 1(16)

DOI: 10.1186/s12888-016-0823-8

Links

Tools

Export citation

Search in Google Scholar

Clinical utility of the Montgomery-Åsberg Depression Rating Scale for the detection of depression among bariatric surgery candidates

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Green circle
Postprint: archiving allowed
Green circle
Published version: archiving allowed
Data provided by SHERPA/RoMEO

Abstract

Abstract Background Clinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Åsberg Depression Rating Scale (MADRS) and the utility of a short version for bariatric surgery candidates. Methods The sample was 374 patients with obesity, consecutively recruited from the waiting list of a bariatric surgery clinic of University Hospital, Brazil: women 80 %, mean BMI 47 kg/m2, mean age 43.0 years. The 10-item MADRS was analyzed against the SCID-I. Items that showed small relevance to sample’s characteristics and contribution to data variability were removed to develop the short 5-item version of scale. We calculated the sensitivity and specificity of cutoff points of both versions MADRS, and values were plotted as a receiver operating characteristic curve. Results For the 10-item MADRS, the Cronbach’s alpha coefficient was 0.93. When compared against SCID-I, the best cut-off threshold was 13/14, yielding sensitivity of 0.81 and specificity 0.85. Following items were removed: reduced appetite, reduced sleep, concentration difficulties, suicide thought and lassitude. The 5-item version showed an alpha coefficient of 0.94 and a best cut-off threshold of 10/11, yielding sensitivity of 0.81 and specificity 0.87. Similar overall ability to discriminate depression of almost 90 % was found for both 10-item and 5-item MADRS. Conclusion The MADRS is a reliable and valid instrument to assess depressive symptoms among treatment-seeking bariatric patients. Systematic application of the abbreviated version of the MADRS can be recommended for enhancing the clinical detection of depression during perioperative period.