Psychometric validity of the Montgomery and Åsberg Depression Rating Scale for Youths (MADRS-Y)

Figures & data

Table 1. Descriptive statistics for MADRS-Y.

	Sample one N = 310				Sample two N = 310				Significance test		Effect size Cohen’s d
Items	Mean	SD	Frequency or range	%	Mean	SD	Frequency or range	%	p	X^2	d
Sex – girls			187	60.3			196	63.2		.457
Age	15.79	1.75	12–20		15.68	1.80	12–20		.443		.06
Parents’ socioeconomic status
Students							2	.6
Manual workers			57	18.4			53	17.1
Clerical or office workers			86	27.7			95	30.6
Higher civil servants			103	33.2			104	33.5
Self-employed			21	6.8			24	7.7
Never used alcohol			201	64.8			206	66.5
Never used drugs			295	95.2			299	96.5
Difficulties (emotional, concentration, behaviour, or relational) (0 = no; 3 = yes, serious difficulties)	0.63	0.76			0.65	0.79			.756		–.02
MADRS-Y total scale	11.39	10.18					12.33	10.66	.262		–.09
MADRS-S total scale (for adults)	9.78	8.16					10.05	8.64	.692		–.03
RADS-2 total scale	1.98	0.50					1.99	0.54	.886		–.01
RCADS Anxiety total scale	21.85	14.60					23.60	17.00	.169		–.11
WHO-5 total scale	59.10	21.73					59.00	21.64	.955		.00
PROMIS Pediatric Short Form v.1.0—Family relationships 8a	25.60	7.54					25.96	6.62	.526		–.05
PROMIS Pediatric Bank v2.0 – Peer relationships	44.61	11.20					44.93	9.89	.707		–.03
PROMIS Pediatric Bank v1.0—Physical activity	19.58	8.98					20.22	8.92	.375		–.23

Note. M = mean, SD = standard deviation, X² = Chi Square test, p = significance of t-test.

Table 2. Internal consistency and T-test between gender, for the Swedish sample of MADRAS-Y total score.

	Boys			Girls			Total			T-test
MADRS-Y total score	M	SD	α	M	SD	α	M	SD	α	T	p	Cohen’s d
	n = 123			n = 187				n = 310
Sample One	8.64	8.26	.88	12.40	10.33	.89	11.39	10.18	.89	2.16	0.032*	0.25
	n = 114			n = 196				n = 310
Sample Two	9.46	10.04	.89	14.00	10.67	.89	12.33	10.66	.89	3.69	0.000***	0.44

Note. M mean, SD standard deviation, α = Cronbach alpha. *= p < .05, *** < p = .001. Effect size Cohen’s d ≥ .2 small effect, ≥ .5 medium effect, and ≥ .8 large effect.

Table 3. Descriptive statistics for MADRS-Y.

	Sample one N = 310				Sample two N = 310
Items of MADRS-Y	Mean	SD	${\mathrm{r}}_{\text{it}}^{\mathrm{c}}$	α-i	Mean	SD	${\mathrm{r}}_{\text{it}}^{\mathrm{c}}$	α-i
1. Sadness	0.91	1.34	0.74	0.87	0.89	1.37	0.64	0.88
2. Irritability	0.98	1.32	0.60	0.88	1.18	1.48	0.66	0.88
3. Anxiety	1.59	1.61	0.69	0.87	1.61	1.60	0.67	0.88
4. Decreased sleep	1.27	1.47	0.56	0.88	1.24	1.37	0.50	0.89
5. Increased sleep	0.57	1.02	0.36	0.89	0.74	1.25	0.43	0.89
6. Decreased appetite	0.61	1.04	0.54	0.88	0.65	1.02	0.49	0.89
7. Increased appetite	0.51	1.15	0.38	0.89	0.48	0.99	0.32	0.90
8. Concentration	1.21	1.45	0.64	0.87	1.39	1.51	0.72	0.88
9. Starting to do things	1.55	1.39	0.60	0.88	1.63	1.35	0.66	0.88
10. Interest and engagement	0.79	1.08	0.62	0.88	0.83	1.06	0.68	0.88
11. Thoughts about yourself and your future	0.81	1.16	0.71	0.87	0.95	1.33	0.76	0.88
12. Life or death thoughts	0.59	1.03	0.68	0.87	0.73	1.23	0.71	0.88

Note. M = mean, SD = standard deviation, ${\mathrm{r}}_{\text{it}}^{\mathrm{c}}$ = corrected item-total correlation, α–i = ordinal alpha if the item is removed.

Table 4. Intercorrelations between MADRS-Y items using Pearson’s r for sample one and sample two.

Measure	1.	2.	3.	4.	5.	6.	7.	8.	9.	10.	11.	12.
1. Sadness	1.000	.478**	.657**	.436**	.251**	.473**	.312**	.479**	.419**	.567**	.673**	.602**
2. Irritability	.535**	1.000	.504**	.350**	.266**	.409**	.321**	.456**	.388**	.419**	.406**	.450**
3. Anxiety	.575**	.526**	1.000	.409**	.241**	.402**	.243**	.506**	.544**	.455**	.574**	.487**
4. Decreased sleep	.316**	.358**	.369**	1.000	.414**	.445**	.205**	.395**	.340**	.415**	.383**	.405**
5. Increased sleep	.210**	.259**	.322**	.367**	1.000	.267**	.226**	.263**	.208**	.243**	.184**	.157**
6. Decreased appetite	.338**	.327**	.392**	.286**	.248**	1.000	.141*	.356**	.285**	.336**	.423**	.462**
7. Increased appetite	.171**	.225**	.166**	.083	.345**	.148**	1.000	.251**	.290**	.236**	.365**	.303**
8. Concentration	.419**	.551**	.477**	.451**	.340**	.340**	.373**	1.000	.633**	.405**	.465**	.438**
9. Starting to do things	.444**	.540**	.486**	.413**	.211**	.330**	.231**	.681**	1.000	.391**	.440**	.381**
10. Interest and engagement	.507**	.491**	.484**	.352**	.341**	.367**	.246**	.569**	.512**	1.000	.522**	.569**
11. Thoughts about yourself and your future	.591**	.532**	.603**	.393**	.303**	.454**	.229**	.596**	.554**	.568**	1.000	.736**
12. Life or death thoughts	.599**	.507**	.505**	.339**	.371**	.463**	.271**	.513**	.452**	.553**	.708**	1.000

Note. *p < 0.05, **p < 0.01. Sample One is in the right upper corner and Sample Two is in the left under corner.

Table 5. Principal Component Analysis (PCA) (Sample One) and Confirmatory Factor Analysis (CFA) (Sample Two) Results for the MADRS-Y.

	PCA in Sample One (N = 310)		CFA in Sample Two (N = 310)
	Rotation method: Oblimin		DWLSSS Robust
Item number and meaning of item	Factor 1	Factor 2	First Model’s factor loadings	Second Model’s factor loadings
1. Sadness	0.64	–0.26	0.78	0.79
2. Irritability	0.71	0.12	0.74	0.75
3. Anxiety	0.67	–0.36	0.75	0.76
4. Decreased sleep	0.71	–0.09	0.59	0.60
5. Increased sleep	0.54	0.51	0.50	0.51
6. Decreased appetite	0.51	–0.02	0.58	0.58
7. Increased appetite	0.42	0.74	0.41	0.41
8. Concentration	0.72	–0.11	0.83	0.77
9. Start to do things	0.69	–0.23	0.78	0.71
10. Interest and engagement	0.81	0.09	0.75	0.76
11. Thoughts about yourself and your future	0.74	–0.06	0.85	0.87
12. Life or death thoughts	0.76	0.01	0.84	0.85

Note. Showing the PCA and CFA model’s factor loadings. Factor loadings over 0.40 appear in bold.

Table 6. Measurement Invariance Goodness of Fit for the One-Factor Model of MADRS-Y.

Invariance	$\chi$^2(df)	CFI	TLI	RSMEA (90% CI)	$\Delta \chi$	$\Delta df$	$\Delta$ CFI	$\Delta$ RSMEA
Sex
Configural	226.965** (106)	0.972	0.965	0.086 (0.071–0.102)
Metric	266.285** (152)	0.974	0.977	0.070 (0.056–0.084)	–39.32	–46	–0.002	0.016 close fit
Scalar	254.720** (163)	0.979	0.983	0.060 (0.046–0.074)	11.57	–11	–0.003	0.01
Age group
Configural	259.728** (106)	0.969	0.962	0.097 (0.082–0.097) close fit
Metric	303.956** (152)	0.969	0.973	0.081 (0.067–0.094)	–44,228	–46	–0.006	0.016 close fit
Scalar	289.404** (163)	0.975	0.979	0.071 (0.057–0.084)	14,552	–11	–0.006	0.01

Note. ** = p < .001. χ2 = Chi square; df = degrees of freedom; CFI = Comparative Fit Index; RMSEA = Root Mean Square Error of Approximation; CI = Confidence Interval; TLI = Tucker-Lewis Index; ΔCFI = Change in Comparative Fix Index. For sex groups (girls and boys) Satorra-Bentler $\Delta \chi$²: Config vs. Metric $\chi$² (46) = 16.63, p = 1.00. Metric vs. Scaler $\chi$² (11) = 5.61, p = 0.90. For age groups: Satorra-Bentler $\Delta \chi$²: Config vs. Metric $\chi$² (46) = 20.22, p = 0.99. Metric vs. Scaler $\chi$² (11) = 6.13, p = 0.86.

Table 7. Pearson’s correlations between MADRS-Y and validity measures.

Measure	MADRS-S	RADS-2	RCADS Anx	WHO-5	PROMIS Family	PROMIS Friends	PROMIS Physical Activity
MADRS-Y Sample One	.895*	.715*	.608*	–.730*	–.406*	–.392*	–.325*
MADRS-Y Sample Two	.899*	.753*	.736*	–.730*	–.417*	–.430*	–.212*

Note. *p < .01.

MADRS-S: Montgomery and Asberg Depression Rating Scale – Self-rated [8]; RADS-2: Reynolds Adolescent Depression Scale Version 2 [37]; RCADS Anx: The Revised Child Anxiety and Depression Scale – total Anxiety scale [34]; WHO-5: WHO Well-being Index [31]; PROMIS Family = PROMIS Pediatric Short Form v.1.0—Family relationships 8a; PROMIS Friends = PROMIS Pediatric Bank v2.0 – Peer relationships; PROMIS Physical Activity = PROMIS Pediatric Bank v1.0—Physical activity [45].

Figure 1. Principal Component Analyses of MADRS-Y total scale and all validity measures. Note. MADRS-S = Montgomery and Asberg Depression Rating Scale – Self-rated [8]; RADS-2 = Reynolds Adolescent Depression Scale Version 2 [32]; RCADS Anx = The Revised Child Anxiety and Depression Scale - total Anxiety scale [34]; WHO-5 = WHO Well-being Index [31]; PROMIS Family = PROMIS Pediatric Short Form v.1.0—Family relationships 8a; PROMIS Friends = PROMIS Pediatric Bank v2.0 – Peer relationships; PROMIS Physical Activity = PROMIS Pediatric Bank v1.0—Physical activity [45].

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Data availability statement

The data that support the findings of this study are available from the corresponding author, M.V, upon reasonable request.