A qualitative investigation of the Montgomery-Åsberg depression rating scale: discrepancies in rater perceptions and data trends in remote assessments of rapid-acting antidepressants in treatment resistant depression.
Gianna Capodilupo, Raymond Blattner, Anita Must, Silvia Gamazo Navarro, Mark Opler
Frontiers in Psychiatry 2024 DOI: 10.3389/fpsyt.2024.1289630 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Qualitative Peer reviewed |
|---|---|
| Sample size | 733 |
| Population | Subjects with treatment-resistant depression in clinical trials of rapid-acting antidepressants |
| Topics | Depression |
| Keywords | Rapid acting antidepressants Rater perception Depression treatment Clinical assessment scales Antidepressant medication Psychiatric symptoms Treatment monitoring |
| Citations | 3 |
| Key findings | MADRS items 'Reduced sleep', 'Apparent sadness', and 'Pessimistic thoughts' showed the greatest average data change by visit, while raters ranked 'Reported sadness', 'Lassitude', and 'Apparent sadness' as the most helpful items for assessing symptom change. |
Abstract
Despite the development of many successful pharmaceutical interventions, a significant subset of patients experience treatment-resistant depression (TRD). Ketamine and its derivatives constitute a novel therapeutic approach to treat TRD; however, standard tools, such as the Montgomery-Åsberg Depression Rating Scale (MADRS) are still being used to measure symptoms and track changes. The aim of this study was to review item-level differences between rate of data change (MADRS score) and rater-weighted perception of the most useful items for assessing change in symptoms while remotely conducting the 10-item version of the MADRS in TRD in a clinical trial of rapid-acting antidepressants. Two studies of rapid-acting antidepressants in the treatment of TRD were used to identify item-scoring trends when MADRS is administered remotely and repeatedly (733 subjects across 10 visits). Scoring trends were evaluated in tandem to a rater survey completed by 75 raters. This was completed to gain insight on MADRS items' perceived level of helpfulness when assessing change of symptoms in rapid-acting antidepressant trials. MADRS items 'Reduced sleep', 'Apparent sadness', and 'Pessimistic thoughts' were found to have the greatest average data change by visit, while raters ranked 'Reported sadness', 'Lassitude' and 'Apparent sadness' as the most helpful items when assessing symptom change. The diversion between rate of data-change ranking and rater perception of helpfulness could be related to difficulty in assessing specific items, to the novel treatment itself, and/or to the sensitivity to symptom change to which raters are accustomed in traditional antidepressant treatments.
Comparable studies
Other observational and cohort studies on depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Residually depressed patients and nondepressed controls; recovered depressed patients | 2002 | Observational cohort with intervention components | |
| Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression | 2017 | Observational cohort | n = 19 |
| Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Patients with a depressive disorder | 2015 | Observational study | |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
Citations in the library
Cites 6
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression American Journal of Psychiatry April 8, 2016
- Ketamine: A tale of two enantiomers Journal of Psychopharmacology November 6, 2020
- KETAMINE'S MECHANISM OF ACTION: A PATH TO RAPID‐ACTING ANTIDEPRESSANTS Depression and Anxiety April 6, 2016
and 1 more in the library