What
are the factors considered important by the
patients in defining remission from
depression?
Achieving
remission is the primary goal of treatment of
depression. Remission is based on scores on
symptom severity scales such as the Hamilton
Depression Scale (HAM-D) and Montgomery-Asberg
Depression Rating Scale (MADRS). However,
normalization of functioning is rarely used to
identify patients in remission. A recent survey
determined the factors depressed patients
considered important in defining remission from
depression.
The study was conducted in 535 psychiatric
outpatients who were being treated for a DSM-IV
major depressive episode. The participants
included 182 men (34.0%) and 353 women who
ranged in age from 21 to 80 years. In a
questionnaire they rated the importance of 16
factors in determining whether their depression
was in remission.
The three items that were the most frequently
considered to be very important in determining
remission included the presence of features of
positive mental health such as optimism and
self-confidence, a return to one’s usual,
normal self, and a return to the usual level of
functioning. Presence of positive mental health,
a return to one’s usual self, a general
sense of well-being, and the absence of symptoms
of depression were four items selected by more
than 10% of the patients as being the most
important factor in determining remission from
depression.
These results demonstrate that patients being
treated for depression hope for optimism, vigor,
and self-confidence as measures of successful
remission. The presence of these positive
features of mental health is a better indicator
of remission than the absence of the symptoms of
depression. Zimmerman
M, McGlinchey JB, Posternak MA, Friedman M,
Attiullah N, Boerescu D. How should remission
from depression be defined? The depressed
patient's perspective. Am J Psychiatry 2006,
163:148-150.