Clinical utility of the Montgomery-Asberg Depression Rating Scale for the detection of depression among bariatric surgery candidates

Autor(es)

Duarte-Guerra, Leorides Severo ^[1] ; Gorenstein, Clarice ^{[2, 1]} ; Paiva-Medeiros, Paula Francinelle ^[1] ; Santo, Marco Aurelio ^[3] ; Neto, Francisco Lotufo ^[1] ; Wang, Yuan-Pang ^{[1, 4]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Dept & Inst Psychiat LIM 23, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Inst Biomed Sci, Dept Pharmacol, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Surg, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Hosp Clin, Fac Med, Inst & Dept Psiquiatria, Rua Dr Ovidio Pires Campos 785, BR-05403010 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: BMC Psychiatry; v. 16, APR 30 2016.
• Citações Web of Science: 3

Resumo

Background: Clinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Asberg Depression Rating Sca (MADRS) and the utility of a short version for bariatric surgery candidates. Methods: The sample was 374 patients with obesity, consecutively recruited from the waiting list of a bariatric surgery clinic of University Hospital, Brazil: women 80 %, mean BMI 47 kg/m(2), mean age 43.0 years. The 10-item MADRS was analyzed against the SCID-I. Items that showed small relevance to sample's characteristics and contribution to data variability were removed to develop the short 5-item version of scale. We calculated the sensitivity and specificity of cutoff points of both versions MADRS, and values were plotted as a receiver operating characteristic curve. Results: For the 10-item MADRS, the Cronbach's alpha coefficient was 0.93. When compared against SCID-I, the best cut-off threshold was 13/14, yielding sensitivity of 0.81 and specificity 0.85. Following items were removed: reduced appetite, reduced sleep, concentration difficulties, suicide thought and lassitude. The 5-item version showed an alpha coefficient of 0.94 and a best cut-off threshold of 10/11, yielding sensitivity of 0.81 and specificity 0.87. Similar overall ability to discriminate depression of almost 90 % was found for both 10-item and 5-item MADRS. Conclusion: The MADRS is a reliable and valid instrument to assess depressive symptoms among treatment-seeking bariatric patients. Systematic application of the abbreviated version of the MADRS can be recommended for enhancing the clinical detection of depression during perioperative period. (AU)

• Processo FAPESP: 12/17498-9 - Espectro do transtorno bipolar entre pacientes obesos candidatos à cirurgia bariátrica
• Beneficiário: Leorides Severo Duarte Guerra
• Modalidade de apoio: Bolsas no Brasil - Mestrado
• Processo FAPESP: 12/17435-7 - Espectro do transtorno bipolar entre pacientes obesos candidatos a cirurgia bariátrica: transtornos mentais e obesidade
• Beneficiário: Wang Yuan Pang
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 12/18325-0 - Sintomas depressivos entre pacientes obesos candidatos à cirurgia bariátrica
• Beneficiário: Paula Francinelle de Medeiros Paiva
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica