Relative sensitivity of the Montgomery-Asberg depression rating scale, the Hamilton depression rating scale and the Clinical Global Impressions rating scale in antidepressant clinical trials: a replication analysis.

Abstract

The present study replicates a previous study in which we found that the less frequently used Montgomery-Asberg Depression Rating Scale (MADRS) is as sensitive an instrument in detecting antidepressant-placebo differences in antidepressant clinical trials as the more widely used Hamilton Depression (HAM-D) rating scale. The Clinical Global Impressions Rating Scale for Severity (CGI-S) was also similar to the other two scales. A retrospective chart review was performed on the records of 139 depressed adult patients who participated in six randomized, placebo-controlled, double-blind antidepressant clinical trials at the North-west Clinical Research Centre between 1996 and 2003. The effect size (measured as the mean change in rating with antidepressants minus the mean change for placebo divided by the pooled SD of change) was 0.68 with MADRS, 0.54 with CGI-S and 0.57 with HAM-D. A correlation analysis also revealed a significant positive relationships between baseline MADRS and HAM-D and final MADRS and HAM-D for the total sample, placebo group, and antidepressant group (P<0.01). Further research is needed to examine which scale is the most appropriate to use for each particular antidepressant clinical trial.