Assessing Clinical Depression According to the MADRS

INTRODUCTION:

According to Kessler et al. (1994) about 17% of people are likely to experience some kind of depression at some point in their lives. Another figure is: around 2.6 million people in England suffered from depression in 2006 (Thomas and Morris. 2003). Brown (2001) even suggests that by 2020 depression will become the second most common disease.

All these alarming figures lead to the question of what depression exactly is and how to asses and treat it.

In the DSM-IV depression is defined by meeting five or more of the following symptoms in a two-week period representing a change in previous functioning:

(1)significant weigh loss / gain

(2)insomnia / hypersomnia

(3)psychomotor agiation or retardation

(4)fatigue / loss of energy

(5)feelings of worthlessness and / or guilt

(6)diminished ability to concentrate / indecisevness

(7)suicide ideation

The criteria must include either a depressed mood or loss of pleasure.

The following study will be concerned with the assessment of depression. In particular we will examine the Montgomery and Asberg Depression rating scale (MADRS).

A standardised assessment system is important for both therapist and patient. With a system that clinicians have agreed upon it is much simpler to align assessments and treatments. It ensures that when three different clinicians interview a patient, they reach similar findings for the final assessment.

Our object is to find out how reliable the MADRS is. The hypothesis will be: if the MADRS is reliable we expect the means of the groups of participants who assess the patient to be similar.

METHOD:

Participants:

The participants in this study were 37 first year psychology students divided into two groups A (n=19) an...

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...he judgement of the patient, too.

Despite these facts the modes of the symptoms show a similar pattern. Group A seem to agree upon the majority of symptoms when looking at the mode. All items except reported sadness and inner tension have a mode of 4. The same applies to group B although here the items which do not follow the pattern of fours are inner tension and reduced appetite.

Inner tension is perceived by both groups similarly.

Our hypothesis at the beginning can be supported. The results do not match exactly but are fairly similar, in particular if one considers the non experience of the groups in regards to depression and its assessment.

In order to receive a more accurate result future studies could introduce a model assessment. An experience clinician could pre rate another patient and explain his / her arguments as to why he assessed his / her way.