Title |
Clinical utility of the Montgomery-Åsberg Depression Rating Scale for the detection of depression among bariatric surgery candidates
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Published in |
BMC Psychiatry, April 2016
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DOI | 10.1186/s12888-016-0823-8 |
Pubmed ID | |
Authors |
Leorides Severo Duarte-Guerra, Clarice Gorenstein, Paula Francinelle Paiva-Medeiros, Marco Aurélio Santo, Francisco Lotufo Neto, Yuan-Pang Wang |
Abstract |
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. 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/m(2), 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. 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. 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. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 86 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 14 | 16% |
Student > Bachelor | 12 | 14% |
Researcher | 11 | 13% |
Student > Ph. D. Student | 9 | 10% |
Student > Postgraduate | 5 | 6% |
Other | 11 | 13% |
Unknown | 24 | 28% |
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Neuroscience | 6 | 7% |
Nursing and Health Professions | 4 | 5% |
Biochemistry, Genetics and Molecular Biology | 3 | 3% |
Other | 12 | 14% |
Unknown | 31 | 36% |