Major Depression Index (MDI)

MDI Calculator
1. Have you felt low in spirits or sad?
2. Have you lost interest in daily activities?
3. Have you felt lacking in energy and strength?
4. Have you felt less self-confident?
5. Have you had a bad conscience or feelings of guilt?
6. Have you felt that life wasn't worth living?
7. Have you had difficulty concentrating?
8. Have you felt very restless?
9. Have you felt subdued or slowed down?
10. Have you had trouble sleeping at night?
Result: 0
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Screens for depression based on clinically significant questions.

Why Use

The MDI can help objectify and rate the severity of a patient's depression.

When to Use

Patients who identify as depressed or who may be suffering from depression. The QIDS can also be trended over time to help providers and patients alike see trends like improvements in depressive symptoms over time.

Formula

Addition of the selected points: Variable Points Ask the patient: how often have they been bothered by the following over the past 2 weeks? 1. Felt low in spirits or sad? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 2. Lost interest in daily activities? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 3. Felt lacking in energy and strength? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 4. Felt less self-confident? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 5. Had a bad conscience or feelings of guilt? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 6. Felt that life wasn’t worth living? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 7. Had difficulty in concentrating, e.g. when reading the newspaper or watching television? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 8a. Felt very restless? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 8b. Felt subdued or slowed down? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 9. Had trouble sleeping at night? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 10a. Suffered from reduced appetite? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5 10b. Suffered from increased appetite? At no time 0 Some of the time 1 Slightly less than half the time 2 Slightly more than half the time 3 Most of the time 4 All the time 5

Advice

Patients with depression should be provided with further resources and potentially referred to psychiatry, as well as be screened for emergency psychiatric conditions like suicidal ideation or psychosis.

More Information

Symptoms are rated based on how the patient has been feeling over the past two weeks. The diagnostic demarcation line indicates at which point a symptom is severe enough to be used in the DSM-IV diagnostic algorithm of major depression. The first three symptoms (mood, interest and fatigue) should have been present at least “most of the time” during the past two weeks, while other symptoms should have been present during “more than half of the time” during the period for diagnosis of major depression. For symptoms 4 and 5 (guilt), only the highest score should be used, as they pertain to the same diagnostic criteria for depression in DSM-IV. For symptoms 8a and 8b (psychomotor changes), only the highest score should be used, as they pertain to the same diagnostic criteria for depression in DSM-IV. For symptoms 10a and 10b (weight/appetite), only the highest score should be used, as they pertain to the same diagnostic criteria for depression in DSM-IV. Major depression is diagnosed if ≥5 of the 9 symptoms (items 4 and 5 combined) have been present in the past two weeks and if symptom 1 or 2 are included in these 5 symptoms. Per the DSM-IV, the 9 diagnostic criteria for Major Depression are (in the order they appear above): Mood Interest Fatigue Guilt Suicidal ideation Concentration Psychomotor changes Sleep Weight/appetite Interpretation: Score Severity of depression <20 No depression 20-24 Mild 25-29 Moderate ≥30 Severe

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