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Administering the MADRS by telephone or face-to-face: a validity study
Marleen L M Hermens1, Herman J Adèr, Hein P J van Hout
1Department of General Practice, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. mlm.hermens@tiscali.nl
Annals of General Psychiatry
|March 24, 2006
Summary
The Montgomery Asberg Depression Rating Scale (MADRS) can be reliably administered by telephone. This study found telephone ratings comparable to in-person assessments for depression, including observational items.
Area of Science:
- Psychiatry
- Clinical Psychology
- Telemedicine
Background:
- The Montgomery Asberg Depression Rating Scale (MADRS) is a standard tool for assessing depression severity.
- Assessing the validity of telephonic administration is crucial for expanding access to mental health evaluations.
- Previous research has not fully established the reliability of telephone-based MADRS, particularly for observational items.
Purpose of the Study:
- To evaluate the validity of using the MADRS via telephone compared to traditional face-to-face assessments.
- To determine if the 'apparent sadness' item, a purely observational component, is reliably assessed remotely.
- To support the use of telemedicine for depression screening and monitoring.
Main Methods:
- A validity study involving 66 primary care patients diagnosed with minor or mild-major depression.
- Trained interviewers administered the MADRS in-person, followed by a telephonic administration a few days later.
- Statistical analysis included calculating the Intraclass Correlation Coefficient (ICC) and homogeneity analysis for the 'apparent sadness' item.
Main Results:
- Mean MADRS scores were similar between in-person (24.0) and telephone (23.5) administrations.
- The ICC for the full scale indicated good reliability (0.65) for telephone administration.
- Homogeneity analysis confirmed that the 'apparent sadness' item integrated well within the telephonically administered scale.
Conclusions:
- The full MADRS scale, encompassing observational items like 'apparent sadness', demonstrates reliable validity when administered via telephone.
- Telephonic administration of the MADRS is a viable and reliable method for assessing depression in primary care settings.
- This finding supports the integration of tele-mental health services for depression assessment and management.