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Psychometric Properties of the Montgomery-Åsberg Depression Rating Scale in Severely Obese Patients

Published online by Cambridge University Press:  14 September 2015

Paula Francielle Paiva-Medeiros
Affiliation:
Universidade de São Paulo (Brazil)
Leorides Severo Duarte-Guerra
Affiliation:
Universidade de São Paulo (Brazil)
Marco Aurélio Santo
Affiliation:
Universidade de São Paulo (Brazil)
Francisco Lotufo-Neto
Affiliation:
Universidade de São Paulo (Brazil)
Yuan-Pang Wang*
Affiliation:
Universidade de São Paulo (Brazil)
*
*Correspondence concerning this article should be addressed to Yuan-Pang Wang. Universidade de São Paulo. Medical School. Rua Dr. Ovídio Pires de Campos, 785. 05403–010. São Paulo (Brazil). Phone/Fax: +55–1126616976

Abstract

Obesity is a chronic condition worldwide and has frequent association with major depression. The Montgomery-Åsberg Depression Rating Scale (MADRS) was applied to obese patients in order to detect briefly and systematically depressive symptoms. The objectives were: to estimate the reliability of the MADRS and to investigate the criterion validity of MADRS. The best cut-off point to detect depressive symptoms was determined in comparison with the Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID-I). The sample was recruited consecutively from the waiting list of a bariatric surgery service of the university clinic. Trained clinical psychologists applied the assessment instruments. The final sample was comprised of 374 class III obese adults (women 79.9 %, mean age 43.3 years [SD 11.6], mean body mass index 47.0 kg/m2 [SD 7.1]). The mean total score of the MADRS was 7.73 (SD 11.33) for the total sample, with a Cronbach’s alpha coefficient of .93. Women presented higher mean score than men (8.08 versus 6.33; p = .23). The best cut-off point was 13/14 in accordance with the Receiver Operating Characteristics (ROC) curve analysis, yielding a sensitivity of .81 and specificity of .85. The overall ability to discriminate depression according to area under the curve was .87. The results showed that the MADRS is a reliable and valid scale to detect depressive symptoms among patients seeking treatment in preoperative period, displaying adequate psychometric properties.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2015 

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References

Alciati, A., Gesuele, F., Rizzi, A., Sarzi-Puttini, P., & Foschi, D. (2011). Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates. International Journal of Psychiatry Medicine, 41, 155171. http://dx.doi.org/10.2190/PM.41.2.e CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic And Statistical Manual Of Mental Disorders DSM-IV-TR Fourth Edition (Text Revision). Washington DC: American Psychiatric Press.Google Scholar
Bromet, E., Andrade, L. H., Hwang, I., Sampson, N. A., Alonso, J., de Girolamo, G., … Kessler, R. C. (2011). Cross-national epidemiology of DSM-IV major depressive episode. BioMed Central Medicine, 9, 90. http://dx.doi.org/10.1186/1741-7015-9-90 Google ScholarPubMed
Bunevicius, A., Staniute, M., Brozaitiene, J., Pommer, A. M., Pop, V. J., Montgomery, S. A., & Bunevicius, R. (2012). Evaluation of depressive symptoms in patients with coronary artery disease using the Montgomery Åsberg Depression Rating Scale. International Clinical Psychopharmacology, 27, 249255. http://dx.doi.org/10.1097/YIC.0b013e328357670d CrossRefGoogle ScholarPubMed
Damaso, A. (2003). Etiologia da obesidade [The etiology of obesity]. Rio de Janeiro, Brazil: Medsi.Google Scholar
de Zwaan, M. (2012). Could Surgery influence Psychopathology more in the long-term than evidence-based psychotherapy? Pros and cons of bariatric surgery in the treatment of obesity. Verhaltenstherapie, 22, 199203. http://dx.doi.org/10.1159/000341543 Google Scholar
Del-Ben, C. M., Rodrigues, C. R., & Zuardi, A. W. (1996). Reliability of the Portuguese version of the structured clinical interview for DSM-III-R (SCID) in a Brazilian sample of psychiatric outpatients. Brazilian Journal of Medical and Biological Research, 29, 16751682.Google Scholar
Dratcu, L., da Costa Ribeiro, L., & Calil, H. M. (1987). Depression assessment in Brazil. The first application of the Montgomery-Asberg Depression Rating Scale. British Journal of Psychiatry, 150, 797800.CrossRefGoogle ScholarPubMed
Duarte-Guerra, L. S., Coelho, B. M., Santo, M. A., & Wang, Y. P. (2015). Psychiatric disorders among obese patients seeking bariatric surgery: Results of structured clinical interviews. Obesity Surgery, 25, 830837. http://dx.doi.org/10.1007/s11695-014-1464-y CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured clinical interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. New York, NY: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Hayden, M. J., Brown, W. A., Brennan, L., & O'Brien, P. E. (2012). Validity of the Beck Depression Inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates. Obesity Surgery, 22, 16661675. http://dx.doi.org/10.1007/s11695-012-0682-4 CrossRefGoogle ScholarPubMed
Hedman, E., Ljotsson, B., Kaldo, V., Hesser, H., El Alaoui, S., Kraepelien, , … Lindefors, N. (2014). Effectiveness of Internet-based cognitive behavior therapy for depression in routine psychiatric care. Journal of Affective Disorders, 155, 4958. http://dx.doi.org/10.1016/j.jad.2013.10.023 CrossRefGoogle ScholarPubMed
Herrmann, N., Black, S. E., Lawrence, J., Szekely, C., & Szalai, J. P. (1998). The Sunnybrook Stroke Study: A prospective study of depressive symptoms and functional outcome. Stroke, 29, 618624. http://dx.doi.org/10.1161/01.STR.29.3.618 CrossRefGoogle ScholarPubMed
IBM Inc. (2009). PASW Statistics for Windows (Version 18.0). Chicago, IL: SPSS Inc.Google Scholar
Kang, H. J., Stewart, R., Kim, J. M., Jang, J. E., Kim, S. Y., Bae, K. Y., … Yoon, J. S. (2013). Comparative validity of depression assessment scales for screening poststroke depression. Journal of Affective Disorders, 147, 186191. http://dx.doi.org/10.1016/j.jad.2012.10.035 CrossRefGoogle ScholarPubMed
Leentjens, A. F., Verhey, F. R., Lousberg, R., Spitsbergen, H., & Wilmink, F. W. (2000). The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson's disease. International Journal of Geriatric Psychiatry, 15, 644649.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Magnil, M., Gunnarsson, R., & Bjorkelund, C. (2011). Using patient-centred consultation when screening for depression in elderly patients: A comparative pilot study. Scandinavian Journal of Primary Health Care, 29(1), 5156. http://dx.doi.org/10.3109/02813432.2011.554011 CrossRefGoogle ScholarPubMed
Mechanick, J. I., Youdim, A., Jones, D. B., Garvey, W. T., Hurley, D. L., McMahon, M. M., … Brethauer, S. (2013). Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, the obesity society, and american society for metabolic & bariatric surgery. Obesity, 21(S1), S1S27. http://dx.doi.org/10.1002/oby.20461 CrossRefGoogle Scholar
Ministério da Saúde do Brasil. (2007). Vigitel Brasil 2006: Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. [Vigitel Brasil 2006: The surveillance of risk and protective factors for chronic diseases by telephone survey]. Brasília, Brazil: Ministério da Saúde.Google Scholar
Ministério da Saúde do Brasil. (2013). Vigitel Brasil 2012: Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico [Vigitel Brazil 2012: The surveillance of risk and protective factors for chronic diseases by telephone survey]. Brasília, Brazil: Ministério da Saúde.Google Scholar
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389. http://dx.doi.org/10.1192/bjp.134.4.382 CrossRefGoogle ScholarPubMed
Mottram, P., Wilson, K., & Copeland, J. (2000). Validation of the Hamilton Depression Rating Scale and Montgommery and Asberg Rating Scales in terms of AGECAT depression cases. International Journal of Geriatric Psychiatry, 15, 11131119. http://dx.doi.org/10.1002/1099-1166(200012)15:12%3C1113::AID-GPS253%3E3.0.CO;2-Y 3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Muller-Thomsen, T., Arlt, S., Mann, U., Mass, R., & Ganzer, S. (2005). Detecting depression in Alzheimer's disease: Evaluation of four different scales. Archives of Clinical Neuropsychology, 20, 271276. http://dx.doi.org/10.1016/j.acn.2004.03.010 CrossRefGoogle ScholarPubMed
Mundt, J. C., Katzelnick, D. J., Kennedy, S. H., Eisfeld, B. S., Bouffard, B. B., & Greist, J. H. (2006). Validation of an IVRS version of the MADRS. Journal of Psychiatry Research, 40, 243246. http://dx.doi.org/10.1016/j.jpsychires.2005.05.002 CrossRefGoogle ScholarPubMed
Murray, C. J. L., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020 (Vol. 1). Cambridge, MA: Harvard University Press.Google Scholar
Mühlhans, B., Horbach, T., & de Zwaan, M. (2009). Psychiatric disorders in bariatric surgery candidates: A review of the literature and results of a German prebariatric surgery sample. General Hospital Psychiatry, 31, 414421. http://dx.doi.org/10.1016/j.genhosppsych.2009.05.004 CrossRefGoogle Scholar
Onyike, C. U., Crum, R. M., Lee, H. B., Lyketsos, C. G., & Eaton, W. W. (2003). Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. American Journal of Epidemiology, 158, 11391147. http://dx.doi.org/10.1093/aje/kwg275 CrossRefGoogle ScholarPubMed
Portugal, G., Coutinho, E. S., Almeida, C., Barca, M. L., Knapskog, A. B., Engedal, K., & Laks, J. (2012). Validation of Montgomery-Asberg Rating Scale and Cornell Scale for Depression in Dementia in Brazilian elderly patients. International Psychogeriatrics, 24, 12911298. http://dx.doi.org/10.1017/s1041610211002250 CrossRefGoogle Scholar
Reijnders, J. S. A. M., Lousberg, R., & Leentjens, A. F. G. (2010). Assessment of depression in Parkinson's disease: The contribution of somatic symptoms to the clinimetric performance of the Hamilton and Montgomery-Asberg rating scales. Journal of Psychosomatic Research, 68, 561565. http://dx.doi.org/10.1016/j.jpsychores.2009.10.006 CrossRefGoogle Scholar
Riedel, M., Moller, H. J., Obermeier, M., Schennach-Wolff, R., Bauer, M., Adli, M., … Seemuller, F. (2010). Response and remission criteria in major depression-a validation of current practice. Journal of Psychiatric Research, 44, 10631068. http://dx.doi.org/10.1016/j.jpsychires.2010.03.006 CrossRefGoogle ScholarPubMed
Sarro, S., Duenas, R. M., Ramirez, N., Arranz, B., Martinez, R., Sanchez, J. M., … San, L. (2004). Cross-cultural adaptation and validation of the Spanish version of the Calgary Depression Scale for Schizophrenia. Schizophrenia Research, 68, 349356. http://dx.doi.org/10.1016/s0920-9964(02)00490-5 CrossRefGoogle ScholarPubMed
Scott, K. M., McGee, M. A., Wells, J. E., & Oakley Browne, M. A. (2008). Obesity and mental disorders in the adult general population. Journal of Psychosomatic Research, 64(1), 97105. http://dx.doi.org/10.1016/j.jpsychores.2007.09.006 CrossRefGoogle ScholarPubMed
Wang, Y. P., & Gorenstein, C. (2013). Assessment of depression in medical patients: A systematic review of the utility of the Beck Depression Inventory-II. Clinics (Sao Paulo) , 68, 12741287. http://dx.doi.org/10.6061/clinics/2013(09)15 CrossRefGoogle ScholarPubMed
Williams, J. B. W., & Kobak, K. A. (2008). Development and reliability of a structured interview guide for the Montgomery Asberg Depression Rating Scale (SIGMA). British Journal of Psychiatry, 192(1), 5258. http://dx.doi.org/10.1192/bjp.bp.106.032532 CrossRefGoogle ScholarPubMed
World Health Organization WHO (2015). Obesity and overweight. Media Center, Fact Sheets. Genève, Switzerland: Author. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/ Google Scholar
Yoon, D. H., Choi, S. H., Yu, J. H., Ha, J. H., Ryu, S. H., & Park, D. H. (2012). The relationship between visceral adiposity and cognitive performance in older adults. Age & Ageing. 41, 456461. http://dx.doi.org/10.1093/ageing/afs018 CrossRefGoogle ScholarPubMed
Zimmerman, M., Chelminski, I., & Posternak, M. A. (2004). Review of studies of the Montgomery-Asberg Depression Rating Scale in controls: Implications for the definition of remission in treatment studies of depression. International Clinical Psychopharmacology. 19(1), 17. http://dx.doi.org/10.1097/00004850-200401000-00001 CrossRefGoogle ScholarPubMed