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. 2002 Nov;72(2):177-84.
doi: 10.1016/s0165-0327(01)00451-7.

Defining remission by cut off score on the MADRS: selecting the optimal value

C J Hawley  1 , T M Gale, T Sivakumaran; Hertfordshire Neuroscience Research group
Affiliations

Defining remission by cut off score on the MADRS: selecting the optimal value

C J Hawley et al. J Affect Disord. 2002 Nov.

Abstract

Background: Remission from major depression may be conceptualised in terms of a cut-off score on an appropriate rating scale. Candidate values proposed hitherto have not been directly validated.

Method: The relationship between The Clinical Global Impression Scale for Severity (CGI-S) and the Montgomery-Asberg Depression Rating Scale (MADRS) was explored in 684 major depressed patients (1114 observations). The value on the MADRS which had greatest concordance with remission, as defined by the CGI-S, was computed using two models. Concordance between clinician and patient judgements of global illness were also compared.

Results and conclusion: The two models yielded optimal definitions of remission of <9 and <10 on the MADRS. Either value offers a workable operationalisation of remission and there is little to choose between them.

Clinical relevance: The data confirm that MADRS <10 should provide the clinician with a valid, and reasonably objectifiable, target for remission

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