Items of the Montgomery-Åsberg Depression Rating Scale Associated With Response to Paroxetine Treatment in Patients With Major Depressive Disorder

Abstract

Objectives: In the present study, we investigated the association between the severity of each symptom evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and responsiveness to treatment in patients with major depressive disorder (MDD) to identify the items that predict treatment response.

Methods: The patients received a diagnosis of MDD if they had a score greater than 20 points on the MADRS. Following admission, 120 patients were enrolled in the study, and 89 patients completed the study. For the first week, a 20-mg/d dose of paroxetine was administered; thereafter, the dose was increased to 40 mg/d. The MADRS was applied at baseline and after 1, 2, 4, and 6 weeks. We defined responders as patients with improvements in their MADRS scores of more than 50% after 6 weeks of treatment. A multiple regression analysis of MADRS scores at 6 weeks was performed to identify patients who responded to treatment.

Results: There was a significant difference between responders and nonresponders in the reported sadness (RS) score for all MADRS items. In the multiple logistic regression analysis, only the RS and concentration difficulties (C) scores showed a significant association with treatment response. Based on the results of χ tests, RS score cutoff values of 2/3 and 3/4 revealed significant differences in the responder rate. None of the cutoff values for the C score revealed significant differences.

Conclusions: The RS score was significantly associated with responsiveness to paroxetine treatment for MDD, with higher RS scores predicting poor responses to treatment.