MADRS: Montgomery-Åsberg Depression Rating Scale
The MADRS (Montgomery-Åsberg Depression Rating Scale) is a 10-item clinician-rated scale that measures depression severity and was designed to be sensitive to change during antidepressant treatment. Total scores range from 0 to 60, and a total of 10 or below is the most widely adopted remission criterion.
For professional reference, research, and education only. Not for diagnosis or medical advice.
MADRS Score Interpreter
Enter a total score to see its range.
10 clinician-rated items, each 0–6. Higher totals indicate more severe depression. Remission is commonly defined as a total ≤10.
Total score Interpretation 35+ Severe depressionMarked symptom burden; warrants active treatment. 20–34 Moderate depressionClinically significant depressive symptoms. 7–19 Mild depressionLow-level symptoms; monitor and reassess. 0–6 Normal / symptom absentWithin the non-depressed range; ≤10 is the common remission criterion. Montgomery & Åsberg (1979). Severity bands per widely used clinical convention (e.g. Snaith 1986). Clinician-administered, not a self-screen.
The MADRS (Montgomery-Åsberg Depression Rating Scale) is a 10-item clinician-rated scale that measures the severity of depression, with totals from 0 to 60. It was designed to be sensitive to change during treatment [1].
What does the MADRS measure?
The Montgomery-Åsberg Depression Rating Scale (MADRS) was developed by Stuart Montgomery and Marie Åsberg in 1979 specifically to detect and measure changes in depression severity during antidepressant treatment. Unlike the HAM-D, which was designed to characterize depression, the MADRS was built to be maximally sensitive to the effects of treatment, making it the preferred outcome measure in most pharmaceutical trials.
The MADRS contains 10 items, each rated on a 7-point scale (0–6), where 0 and 6 are the anchor points and 2, 4 represent intermediate grades. The items assess both observable and subjective aspects of depression, with a deliberate emphasis on psychological symptoms over somatic symptoms – reducing the confounding effects of physical illness that can artificially elevate HAM-D scores.
The MADRS is clinician-administered: it is not designed for self-report and requires a trained assessor. For a self-report depression measure, use the PHQ-9.
Total scores range from 0 to 60; ≤10 is the widely adopted remission criterion in antidepressant trials. Check the copyright holder's terms before clinical or commercial use of the MADRS.
How do you give the MADRS?
A trained clinician conducts a semi-structured interview with the client and rates each of the 10 items on a 7-point scale from 0 to 6:
- Anchors. Each item has defined anchor points at 0 (symptom absent), 2, 4 and 6 (most severe).
- Odd scores. 1, 3 and 5 are used for intermediate presentations.
- Time. Administration typically takes 15 to 30 minutes.
The 10 MADRS items
Each item scored 0–6. Items reflect the core domains of clinical depression assessment.
How do you score and interpret the MADRS?
Item ratings are summed for a total from 0 to 60. Enter a MADRS total score (0–60) in the interpreter above to see the corresponding severity band and clinical meaning.
Severity bands in common use [2]: 0–6 normal or symptom absent, 7–19 mild, 20–34 moderate, and 35–60 severe depression. ≤10 is the remission criterion adopted by most antidepressant trials.
Clinician-rated scale. Requires trained assessor for valid scoring.
Psychometric properties
The MADRS was built from the 10 items, out of 17 common symptoms of primary depressive illness, that showed the largest changes with treatment in 64 participants across studies of four antidepressants [1]. Inter-rater reliability was high, scores correlated significantly with the Hamilton Rating Scale (HRS), and the MADRS differentiated responders from non-responders to antidepressant treatment better than the HRS, indicating greater sensitivity to change.
Limitations
- Requires a trained rater. Scores depend on interview skill and rater training; it is not a self-screen.
- Not a diagnosis. A MADRS total rates severity; it does not establish a depressive disorder.
- Less emphasis on somatic symptoms. This reduces confounding by physical illness, but the scale captures somatic features of depression less fully than the HAM-D.
MADRS vs HAM-D vs PHQ-9
Choosing the right depression scale depends on clinical setting, rater, and purpose.
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
Related
Billing
In the US, the MADRS: Montgomery-Åsberg Depression Rating Scale is usually billed under these CPT codes. Payer rules vary.
Assessments
- BDI-II Scoring Guide · Beck Depression Inventory
- CES-D: Center for Epidemiologic Studies Depression Scale
- CES-DC Scoring · Center for Epidemiologic Studies Depression Scale for Children
- Beck Anxiety Inventory (BAI) Scoring & Interpretation
- GAD-7 Scoring and Interpretation
- HAM-A: Hamilton Anxiety Rating Scale
Dot size shows how strongly each scale's condition is linked to this one in HiBoop's co-occurrence map.
Common paths
- Cognitive Behavioural Therapy
CBT and the other main psychotherapies outperformed care as usual and waiting list in a network meta-analysis of 331 RCTs with 34,285 participants.
Cuijpers P, et al. World Psychiatry. 2021;20(2):283–93. - Acceptance & Commitment Therapy
ACT reduced depressive symptoms compared with control groups in a meta-analysis of 18 studies with 1,088 participants.
Bai Z, et al. J Affect Disord. 2020;260:728–37.
FAQ
What is the MADRS?
The Montgomery-Åsberg Depression Rating Scale (MADRS) is a 10-item clinician-administered scale developed in 1979 to measure depression severity. It was specifically designed to detect changes in depressive symptoms during antidepressant treatment, making it more sensitive to treatment effects than earlier scales like the HAM-D.
How are MADRS scores interpreted?
MADRS scores range from 0 to 60. Scores of 0–6 indicate no depression or remission, 7–19 represent mild depression, 20–34 indicate moderate depression, and 35–60 reflect severe depression. A score of 10 or below is the most widely adopted remission criterion in antidepressant clinical trials.
What is the difference between the MADRS and the PHQ-9?
The MADRS is clinician-administered and requires a trained assessor to rate symptoms through a structured interview. The PHQ-9 is a self-report questionnaire completed without a clinician present. The MADRS places less emphasis on somatic symptoms and is the preferred outcome measure in antidepressant clinical trials, while the PHQ-9 is better suited for routine screening and primary care.
How is the MADRS administered?
A trained clinician conducts a semi-structured interview with the client and rates each of the 10 items on a 7-point scale from 0 to 6, where 0 represents absence of the symptom and 6 represents the most severe level. Each item has defined anchor points at 0, 2, 4, and 6, with odd scores used for intermediate presentations. Administration typically takes 15 to 30 minutes.
HiBoop does not offer this scale. This page is reference material.This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.