During a consensus conference supported by the MacArthur Foundation,

Frank and colleagues10 came up with a number of operational definitions to assess the complex course of depressive disorders. Partial MK0683 chemical structure remission is defined as a period of time with some improvement of symptoms, but. not of enough magnitude as to achieve full remission, and with the persistence of some residual symptoms. Inhibitors,research,lifescience,medical This state corresponds to a score of 8 to 15 on the Hamilton Rating Scale for Depression (HAM-D17). Conversely, full remission is obtained where clinical improvement, is such that the patient becomes almost asymptomatic. Clinical remission is usually defined by a score of 7 or less on the HAM-D17 or a score of 1012 or less on the Montgomery Åsberg Depression Rating Scale (MADRS). Zimmerman and Colleagues“ have analyzed the implications of using various cutoff scores on symptom severity scales in order to define clinical remission in depressed patients as part, of the Rhode Island Method to Improve Diagnostic Assessments and Services (MIDAS) project. They also assessed the association Inhibitors,research,lifescience,medical between remission status and psychosocial impairments for different cutoff scores for remission in 303 depressed outpatients using the MADRS, the HAM-D17, and an index of the DSM-IV remission status. For both severity scales, the different,

levels of cutoff scores were associated with different rates of remission. Inhibitors,research,lifescience,medical ‘The Inhibitors,research,lifescience,medical high cutoff scores were also associated with higher rates of psychosocial impairment. These results may suggest, that the lower the cutoff scores used to define remission, the more valid

the results may be in term of clinical relevance and quality of life assessment, after antidepressant therapy. A valuable approach of interest to practising psychiatrists has been proposed by Mclntyre and Colleagues,12 who have designed a shorter version of the HAM-D17 using 7 items out of the 17 items of the original scale, based on frequency and sensitivity to changes after antidepressant Inhibitors,research,lifescience,medical treatment. The authors then attempted to validate this shortened questionnaire, called the Toronto HAM-D7, in a sample of 292 patients with major depression followed up in a depression clinic in Toronto. The results indicate that a score of three or less on the Toronto HAM-.D7 did correlate with the score of seven or less for remission on the 17 items of the HAM-D17. Oxalosuccinic acid If this is confirmed in additional validation studies, the Toronto HAM-D7 Scale could be of practical use for general practitioners and for psychiatrists, as well as for use as a screening tool to be used in some antidepressant trials. An American College of Neuropsychopharmacology (ACNP) Task Force reached consensus guidelines after conducting a critical review of the literature and exchanging expert clinical experience. The ACNP Task Force then made several recommendations, which are, however, generally not. evidence-based, on the concept, of remission in major depressive disorders.