Evaluation
of remission in depressed patients with a
self-report questionnaire
Depressed
patients who respond to treatment are often left
with residual symptoms that predict a high
degree of recurrence of a depressive syndrome.
Remission is evaluated through an
interviewer-rated measure of depression severity
such as the Hamilton Depression Rating Scale in
antidepressant efficacy trials. However such
clinician-rated depression symptom severity
scales require too much time to be routinely
used in clinical practice. In contrast
self-report questionnaires represent a time- and
cost-effective alternative for evaluating
depressed patients' remission status in a
thorough, systematic, reliable, and valid
manner. A cutoff on a self-report questionnaire
corresponding to the Hamilton depression scale
definition of remission has been determined in a
recent study.
The study enrolled 303 patients treated for a
DSM-IV major depressive episode, rated on the
17-item Hamilton depression scale. Of these 267
patients completed a self-report depression
questionnaire, the Clinically Useful Depression
Outcome Scale (CUDOS), which contains 18 items
(each scoring 0 to 4) assessing the DSM-IV
inclusion criteria for major depressive
disorder, psychosocial impairment and quality of
life. There was a high degree of agreement
between the brief self-report depression
questionnaire CUDOS (which takes only 2 to 3
minutes to complete) and assessments using the
Hamilton depression scale. The standard HDRS17
definition of remission (a score of 7 or less)
was found to be equivalent to a score of > 20
on the CUDOS.
Self-report questionnaires such as CUDOS thus
represent an interesting tool that can be
routinely administered in clinical practice at
follow-up visits for evaluating the course of
treatment and determining whether patients are
remitted from depression. Zimmerman
M, Posternak M, Chelminski I. Using a
self-report depression scale to identify
remission in depressed outpatients. Am J
Psychiatry 161: 1911-1913, 2004.