Relationship between Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) total scores in older adults with major depressive disorder: An analysis of the OPTIMUM clinical trial

Helena K. Kim, Eric J. Lenze, Nicholas J. Ainsworth, Daniel M. Blumberger, Patrick J. Brown, Alastair J. Flint, Jordan F. Karp, Helen Lavretsky, Emily Lenard, J. Philip Miller, Charles F. Reynolds, Steven P. Roose, Benoit H. Mulsant

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) are commonly used scales to measure depression severity in older adults. Methods: We utilized data from the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) clinical trial to produce conversion tables relating PHQ-9 and MADRS total scores. We split the sample into training (N = 555) and validation samples (N = 187). Equipercentile linking was performed on the training sample to produce conversion tables for PHQ-9 and MADRS. We compared the original and estimated scores in the validation sample with Bland-Altman analysis. We compared the depression severity level using the original and estimated scores with Chi-square tests. Results: The Bland-Altman analysis confirmed that differences between the original and estimated scores for at least 95 % of the sample fit within 1.96 standard deviations of the mean difference. Chi-square tests showed a significant difference in the proportion of participants at each depression severity category determined using the original and estimated scores. Limitations: The conversion tables should be used with caution when comparing depression severity at the individual level. Conclusions: Our conversion tables relating PHQ-9 and MADRS scores can be used to compare treatment outcomes using aggregate data in studies that only used one of these scales.

Original languageEnglish
Pages (from-to)651-658
Number of pages8
JournalJournal of affective disorders
Volume361
DOIs
StatePublished - Sep 15 2024

Keywords

  • Depression
  • Equating
  • Equipercentile linking
  • Late life depression
  • MADRS
  • Major depressive disorder
  • PHQ-9

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