Major Depression Index MDI Calculator

How does this major depression index MDI calculator work?

This health tool is based on the MDI model, a self report questionnaire that was developed by WHO – World Health Organization, that offers a screening system for people suffering from depression signs and checks the severity of the symptoms experienced.

This major depression index MDI calculator can be used both as a first test to provide information about the current situation of the patient and to allow the clinician direct the patient towards the most suitable treatment method but also as an assessment used to show trends and changes in the subject’s experienced depression symptoms.

There are 12 questions that relate to day to day activities, feelings and reactions and these are each score based on their frequency as related by the subject in regard to the past two weeks.

■ The first items concern mood, interest and energy levels:

1. Low in spirits or sad;

2. Lost interest in your daily activities;

3. Lacking in energy and strength;

■ Items 4 and 5 regard guilt and self confidence while 6 and 7 have to do with concentration and life motivation. Item 6 being the one to reveal suicidal ideations.

4. Less self-confident;

5. Bad conscience or feelings of guilt;

6. Feeling that life wasn’t worth living;

7. Difficulty in concentrating;

■ Items 8a and 8b focus on psychomotor changes while items 10a and 10b ask about weight and appetite habits.

8a. Feeling very restless;

8b. Feeling subdued or slowed down;

9. Trouble sleeping at night;

10a. Reduced appetite;

10b. Increased appetite;

Each of the questions has the following answer choices:

■ At no time (0 points)

■ Some of the time (1 point)

■ Slightly less than half of the time (2 points)

■ Slightly more than half of the time (3 points)

■ Most of the time (4 points)

■ All the time (5 points)

MDI score interpretation

Based on the fact that there are 12 questions but q8 and q10 have a and b subdivisions, obtainable scores range between 0 and 50 with 0 being no depression and 50 being severe, major depression. There are cut off points at 20, 25 and 30 and the diagnosis suggests 30 to be the point where major depression is experienced.

■ A score between 20 - 24 indicates mild depression.

■ A score between 25 - 29 indicates moderate depression.

■ Any score ≥30 indicates severe depression.

This score result allows the clinician to quickly assess the symptoms presented by the subject and to proceed with the necessary treatment or refer the patient to another specialist, potential a psychiatrist, especially in cases where suicidal ideations are present.

In the original model there is also another interpretation based on the frequency of answers and to both DSM-IV major depression and ICD-10 moderate to severe depression especially “most of the time” and “all the time” type of answers in different groups of items e.g. first three. A score of 4 or 5 points in at least:

■ 2 of the first 3 items + 2 of the first 7 items consistent with Mild depression ICD-10;

■ 2 of the first 3 items + 4 of the first 7 items consistent with Moderate depression ICD-10;

■ all of the first 3 items + 5 of the first 7 items consistent with Severe depression ICD-10;

■ 1 of the first 2 items + 5 of all 9 items consistent with Major depression DSM-IV.

Major depression common signs

As it is the case with many mental health conditions, not all people develop the main symptoms and even serious cases may remain unnoticed for several periods of time. In some cases the severity degree of the symptoms varies although the overall score is similar. Symptoms in depression can be divided into age groups, gender or combinations with other illnesses such as bipolar disorder, anxiety or attention deficit disorders.

In adults, the most commonly met symptoms are these presented below:

■ Persistent sadness or feelings of emptiness, hopelessness or guilt.

■ Fatigue accompanied by lack of interest.

■ Irritability, worry, anxiousness.

■ Suicidal thoughts.

■ Physical pains of different intensities.

■ Eating or sexual behaviour disorders.

■ Sleep and biological patterns interrupted.

References

1) Bech P, Rasmussen NA, Olsen LR, Noerholm V, Abildgaard W. (2001) The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord; 66(2-3):159-64.

2) Olsen LR, Jensen DV, Noerholm V, Martiny K, Bech P. (2003) The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychol Med; 33(2):351-6.