Montgomery-Åsberg Depression Rating Scale (MADRS)

Client Information

Name: Date:

Gender: Birthday:

Contact Information

Phone number: Email Address:

Address:

Instructions

The assessment should be based on a clinical interview that progresses from broadly worded symptoms questions to more

specific ones that enable an accurate assessment of severity. The rater must determine if the rating falls between steps (1,

3, 5) or on the defined scale steps (0, 2, 4, 6), and then report the right number.

The evaluations must take into account how the patient has performed throughout the previous week.

1. Apparent sadness 0 - No sadness.

1 -

Representing despondency, gloom, and despair 2 - Looks dispirited but does brighten up without difficulty.

(more than just ordinary transient low spirits), 3 -

reflected in speech, facial expression, and posture. 4 - Appears sad and unhappy most of the time.

Rate by the depth and inability to brighten up. 5 -

6 - Looks miserable all the time. Extremely despondent.

0 - Occasional sadness in keeping with the

2. Reported sadness
circumstances.

1 -

Representing reports of depressed mood, regardless

2 - Sad or low but brightens up without difficulty.

of whether it is reflected in appearance or not.

3 -

Includes low spirits, despondency or the feeling of

4 - Pervasive feelings of sadness or gloominess. The
being beyond help and without hope.
mood is still influenced by external circumstances.

5 -

6 - Continuous or unvarying sadness, misery or

despondency.

3. Inner tension 0 - Placid. Only fleeting inner tension.

1 -

Representing feelings of ill-defined discomfort, 2 - Occasional feelings of edginess and ill-defined

edginess, inner turmoil, mental tension mounting discomfort.

to either panic, dread or anguish. Rate according 3 -

to intensity, frequency, duration and the extent of 4 - Continuous feelings of inner tension or intermittent

reassurance called for. panic which the patient can only master with some

difficulty.

5 -

6 - Unrelenting dread or anguish. Overwhelming panic.

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 4. Reduced sleep 0 - Sleeps as normal.

1 -

Representing the experience of reduced duration or 2 - Slight difficulty dropping off to sleep or slightly
depth of sleep compared to the subject's own normal reduced, light or fitful sleep

pattern when well. 3 -

4 - Moderate stiffness and resistance

5 -

6 - Sleep reduced or broken by at least 2 hours.

5. Reduced appetite 0 - Normal or increased appetite.

1 -

Representing the feeling of a loss of appetite 2 - Slightly reduced appetite.

compared with when-well. Rate by loss of desire for 3 -

food or the need to force oneself to eat. 4 - No appetite. Food is tasteless.

5 -

6 - Needs persuasion to eat at all.

6. Concentration difficulties 0 - No difficulties in concentrating.

1 -

Representing difficulties in collecting one's thoughts 2 - Occasional difficulties in collecting one's thoughts.

mounting to an incapacitating lack of concentration. 3 -

Rate according to intensity, frequency, and degree of 4 - Difficulties in concentrating and sustaining thought
incapacity produced. which reduced ability to read or hold a conversation.

5 -

6 - Unable to read or converse without great difficulty.

7. Lassitude 0 - Hardly any difficulty in getting started. No

sluggishness.

Representing difficulty in getting started or slowness 1 -

in initiating and performing everyday activities. 2 - Difficulties in starting activities.

3 -

4 - Difficulties in starting simple routine activities which

are carried out with effort.

5 -

6 - Complete lassitude. Unable to do anything without

help.

8. Inability to feel 0 - Normal interest in the surroundings and in other

people.

Representing the subjective experience of reduced 1 -

interest in the surroundings, or activities that normally 2 - Reduced ability to enjoy usual interests.

give pleasure. The ability to react with adequate 3 -

emotion to circumstances or people is reduced. 4 - Loss of interest in the surroundings. Loss of feelings
for friends and acquaintances.

5 -

6 - The experience of being emotionally paralysed,

inability to feel anger, grief or pleasure and a complete or
even painful failure to feel for close relatives and friends.

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 9. Pessimistic thoughts 0 - No pessimistic thoughts.

1 -

Representing thoughts of guilt, inferiority, self-reproach, 2 - Fluctuating ideas of failure, self-reproach or self-
sinfulness, remorse and ruin. depreciation.

3 -

4 - Persistent self-accusations, or definite but still

rational ideas of guilt or sin. Increasingly pessimistic
about the future.

5 -

6 - = Delusions of ruin, remorse or irredeemable sin.

Self- accusations which are absurd and unshakable.

10. Suicidal thoughts 0 - Enjoys life or takes it as it comes.

1 -

Representing the feeling that life is not worth living, that 2 - Weary of life. Only fleeting suicidal thoughts.

a natural death would be welcome, suicidal thoughts, 3 -

and preparations for suicide. Suicide attempts should 4 - Probably better off dead. Suicidal thoughts are
not in themselves influence the rating. common, and suicide is considered as a possible
solution, but without specific plans or intention.

5 -

6 - Explicit plans for suicide when there is an

opportunity. Active preparations for suicide.

© 1979 The Royal College of Psychiatrists. The Montgomery Åsberg Depression Rating Scale may be photocopied by individual
researchers or clinicians for their own use without seeking permission from the publishers. The scale must be copied in full and all
copies must acknowledge the following source: Montgomery, S.A. & Åsberg, M. (1979). A new depression scale designed to be sensitive
to change. British Journal of Psychiatry, 134, 382-389. Written permission must be obtained from the Royal College of Psychiatrists for
copying and distribution to others or for republication (in print, online or by any other medium).

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