New Insights About the Psychometric Properties of the Montgomery‐Asberg Depression Rating Scale

Abstract

ABSTRACT Objectives This study aimed to comprehensively investigate the psychometric properties of the Montgomery‐Åsberg Depression Rating Scale (MADRS) in a sample from Northeast Brazil. Methods Data were obtained from a cross‐sectional study of 303 participants with depressive disorders assessed using the MINI 7.02, MADRS, GAD‐7, and ASSIST 3.0. We evaluated reliability, construct validity, convergent and discriminant validity, and diagnostic accuracy. Results Regarding reliability, the instrument demonstrated robust internal consistency, supported by strong Cronbach's alpha and McDonald's omega coefficients. In terms of construct validity, Exploratory Factor Analysis (EFA) indicated a single‐factor solution, while the H‐index supported a replicable latent structure. However, formal assessments of closeness to unidimensionality suggested that the scale is not strictly unidimensional. For convergent and discriminant validity, correlational analyses showed a moderate association with anxiety symptoms and weak associations with substance use measures, respectively. Regarding accuracy, ROC curve analysis indicated that a cutoff score of 9 is useful for screening, whereas 18 may better identify a depressive episode. Conclusion While the MADRS remains a valuable tool, structural refinements could further enhance its psychometric performance across distinct clinical settings.