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 MONTGOMERY AND ASBERG DEPRESSION RATING SCALE
Br. J. Psychiat. (1979), 134, 382-389
©Stuart Montgomery 1978, Measures of Depression, Fulcrum Press, London

The rating should be based on a clinical interview moving from broadly phrased questions about symptoms to more detailed ones which allow a precise rating of severity. The rater must decide whether the rating lies on the defined scale steps (0, 2, 4, 6) or between them (1, 3, 5) and then report the appropriate number. The items should be rated with regards to how the patient has done over the past week.  


1 - APPARENT SADNESS - Representing despondency, gloom and despair, (more than just ordinary transient low spirits) reflected in speech, facial expression, and posture. Rate by depth and inability to brighten up.

 

0

No sadness

 

1

 

 

2

Looks dispirited but does brighten up without difficulty

 

3

 

 

4

Appears sad and unhappy most of the time

 

5

 

 

6

Looks miserable all the time. Extremely despondent.


2 - REPORTED SADNESS - Representing reports of depressed mood, regardless of whether it is reflected in appearance or not. Includes low spirits, despondency or the feeling of being beyond help and without hope. Rate according to intensity, duration and the extent to which the mood is reported to be influenced by events.

 

0

Occasional sadness in keeping with the circumstances.

 

1

 

 

2

Sad or low but brightens up without difficulty.

 

3

 

 

4

Pervasive feelings of sadness or gloominess. The mood is still influenced by external circumstances.

 

5

 

 

6

Continuous or unvarying sadness, misery or despondency.


3 - INNER TENSION - Representing feelings of ill-defined discomfort, edginess, inner turmoil, mental tension mounting to either panic, dread or anguish. Rate according to intensity, frequency, duration and the extent of reassurance called for.

 

0

Placid. Only fleeting inner tension.

 

1

 

 

2

Occasional feelings of edginess and ill-defined discomfort

 

3

 

 

4

Continuous feelings of inner tension or intermittent panic which the patient can only master with some difficulty.

 

5

 

 

6

Unrelenting dread or anguish. Overwhelming panic.


4 - REDUCED SLEEP - Representing the experience of reduced duration or depth of sleep compared to the subject's own normal pattern when well.

 

0

Sleeps as usual.

 

1

 

 

2

Slight difficulty dropping off to sleep or slightly reduced, light or fitful sleep

 

3

 

 

4

Sleep reduced or broken by at least two hours.

 

5

 

 

6

Less than two or three hours sleep.


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