Reliability and validity of the telephone-based version of the Montgomery-Asberg depression rating scale for assessing depression in individuals with primary brain tumour

Figures & data

Figure 1. Participant Recruitment Flow Chart.

Table 1. Summary of Participants’ Demographic and Tumour-related Characteristics (n = 50).

Characteristics	M (SD), range, N (%)
Age (years)	46.58 (13.37), 22–81
Gender
Male	28 (56)
Female	22 (44)
Years of education	14.50 (2.74), 10–25
Relationship status
Single	9 (18)
Defacto	5 (10)
Married	31 (62)
Divorced	3 (6.0)
Widowed	2 (4.0)
Employment status
Full-time	8 (16)
Part-time	6 (12)
Paid Leave	6 (12)
Income Protection	2 (4)
Retired	11 (22)
Unemployed	16 (37)
Volunteer	1 (2.0)
Previous mental health history^a	14 (28)
WHO Tumour Grade
I	14 (28)
II	14 (28)
III	10 (20)
IV	12 (24)
Tumour type
Benign	16 (32)
Lower grade glioma	12 (24)
High grade glioma	22 (44)
Treatment history
Chemotherapy	3 (6.0)
Radiotherapy	3 (6.0)
Surgery	9 (18)
Steroids	1 (2)
Chemotherapy + Radiotherapy	3 (6)
Chemotherapy + Radiotherapy + Surgery	13 (26)
Surgery + Steroids	5 (10)
All of above	13 (26)
Tumour recurrence	7 (14)

^aFormal diagnosis of a mental health condition and/or sought mental health treatment prior to the brain tumour. WHO= 2016 World Health Organisation Classification of Tumours of the Central Nervous System.

Table 2. Descriptive Data and Intraclass Correlation Coefficients for the MADRS.

MADRS item (0–6)	Rater 1 M(SD)	Rater 2 M(SD)	Intraclass correlation coefficient (ICC)^a	Standard error of measurement (SEM)	Confidence intervals (95th %tile) Lower–Upper
Total MADRS (0–60)	19.38 (7.50)	19.08 (8.07)	0.98 (Excellent)	1.06	0.96–0.99
Reported sadness	2.36 (1.44)	2.20 (1.47)	0.92 (Excellent)	0.41	0.87–0.96
Apparent sadness	1.58 (1.37)	1.66 (1.38)	0.94 (Excellent)	0.34	0.89–0.97
Tension	2.82 (1.43)	2.80 (1.48)	0.87 (Good)	0.52	0.77–0.93
Sleep	1.98 (1.44)	2.04 (1.49)	0.90 (Good)	0.46	0.82–0.94
Appetite	1.54 (1.23)	1.60 (1.30)	0.93 (Excellent)	0.33	0.88–0.96
Concentration	2.70 (1.23)	2.80 (1.34)	0.96 (Excellent)	0.25	0.93–0.98
Lassitude	1.92 (1.22)	2.06 (1.23)	0.88 (Good)	0.42	0.79–0.93
Inability to Feel	1.50 (1.43)	1.58 (1.41)	0.90 (Good)	0.45	0.83–0.95
Pessimism	2.32 (1.31)	1.94 (1.31)	0.83 (Good)	0.54	0.68–0.90
Suicidal ideation	0.62 (1.12)	0.40 (0.85)	0.93 (Excellent)	0.30	0.86–0.97

Note. ^aICC interpretation: 0.5–<0.75 = moderate reliability, 0.75–0.9 = good reliability, >0.90 = excellent.

Table 3. Pearson’s Correlations Assessing Associations between the MADRS and Other Measures of Depression and Psychological Distress (95^th percentile confidence intervals are shown in brackets).

Measures	MADRS	DASS-Depression	GAD-7	DT
MADRS	–
DASS-depression	0.76 (0.61–0.86)^b	–
GAD-7	0.65 (0.47–0.79)^b	0.68(0.49–0.81)^b	–
DT	0.50 (0.26–0.68)^b	0.38(0.11–0.59)^a	0.50 (0.26–0.69)^b	–

DT: distress thermometer; GAD-7: generalised anxiety disorder scale; MADRS: montgomery-asberg depression rating scale; ^ap < 0.01, ^bp < 0.001.

Table 4. Between Group Comparisons for Demographic and Tumour-Related Characteristics on Depression Symptoms Measured by the MADRS.

Demographic and tumour characteristics	Median (Q1–Q3)	U/H	p
Gender		339	0.54
Female (n = 22)	19 (15–25)
Male (n = 28)	19 (15–22)
Relationship Status		245.5	0.72
Single (n = 15)	22 (10–29)
In a relationship (n = 35)	19 (16–22)
Previous Mental Health History^a		322.5	0.2
Yes (n = 15)	21 (17–26)
No (n = 35)	18 (14–23)
Treatment Type
Surgery		136	0.71
Yes (n = 43)	19 (15–23)
No (n = 7)	19 (17–32)
Chemotherapy		354.5	0.13
Yes (n = 33)	20 (15.5–25.5)
No (n = 17)	18 (12.5–21.5)
Radiotherapy		348	0.11
Yes (n = 34)	20 (15.75–25.25)
No (n = 16)	17.5 (11.25–21.75)
Steroids		344.5	0.71
Yes (n = 22)	19 (15.75–24.5)
No (n = 28)	19 (14–22.75)
Tumour Stage (initial vs. recurrence)		139.5	0.76
Initial (n = 43)	19 (15–24)
Recurrence (n = 7)	18 (16–22)
Tumour type		0.57	0.75
Benign (n = 16)	19.5 (16.25–22)
Lower Grade Glioma  (n = 12)	17 (8.25–26.75)
High Grade Glioma (n = 22)	19.5 (15–24)
WHO Tumour Grade		2.52	0.47
I (n = 14)	19.5 (15.75–25.25)
II (n = 14)	18 (8.75–23)
III (n = 10)	20.5 (17.75–29.25)
IV (n = 12)	16.5 (14.25–22.75)

^aPrevious history of mental health problems was determined by a set of questions asked at the end of the MADRS which related to either a formal diagnosis of a mental health condition or the person sought treatment for mental health issues prior to the brain tumour.

Data availability statement

Raw data were generated at Griffith University. Derived data supporting the findings of this study are available from the corresponding author [TO] on request.