PMID- 15003068
OWN - NLM
STAT- MEDLINE
DCOM- 20040419
LR  - 20220408
IS  - 0160-6689 (Print)
IS  - 0160-6689 (Linking)
VI  - 65
IP  - 2
DP  - 2004 Feb
TI  - Defining remission on the Montgomery-Asberg depression rating scale.
PG  - 163-8
AB  - OBJECTIVE: In antidepressant efficacy trials, it is common to define treatment 
      remission as a score below a cutoff on symptom severity measures. No consensus 
      has emerged regarding an appropriate cutoff for defining remission on the 
      Montgomery-Asberg Depression Rating Scale (MADRS). The goal of the present study 
      was to establish an empirically based cutoff on the MADRS for defining remission. 
      METHOD: 303 psychiatric outpatients being treated for a DSM-IV major depressive 
      episode were rated on the Standardized Clinical Outcome Rating for Depression, an 
      index of DSM-IV remission status; the MADRS; and the Global Assessment of 
      Functioning (GAF) scale. We examined the sensitivity, specificity, and overall 
      classification rate of the MADRS for identifying a broad and narrow 
      interpretation of the DSM-IV definition of remission, as well as the association 
      between the breadth of the definition of remission and psychosocial functioning. 
      RESULTS: On the basis of a narrow definition of remission, which requires a 
      complete absence of clinically significant symptoms of depression, the optimal 
      MADRS cutoff was < or = 4. On the basis of a broader definition, the optimal 
      cutoff was < or = 9. Compared with patients scoring 5 through 9 on the MADRS, 
      those who met the narrow definition of remission were rated higher, indicating 
      better functioning, on the GAF and reported significantly less psychosocial 
      impairment (p <.05). CONCLUSION: Our results support the use of a low cutoff on 
      the MADRS to define remission. Because the choice of cutoff will impact the 
      percentage of patients who are considered to be in remission and thus impact 
      conclusions about treatment effectiveness, more empirical study should be 
      directed toward this issue.
FAU - Zimmerman, Mark
AU  - Zimmerman M
AD  - Department of Psychiatry and Human Behavior, Brown University School of Medicine, 
      Bayside Medical Center, 235 Plain Street, Providence, R.I. 02905, USA. 
      mzimmerman@lifespan.org
FAU - Posternak, Michael A
AU  - Posternak MA
FAU - Chelminski, Iwona
AU  - Chelminski I
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Antidepressive Agents)
SB  - IM
MH  - Activities of Daily Living/classification/psychology
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antidepressive Agents/*therapeutic use
MH  - Depressive Disorder, Major/diagnosis/*drug therapy/psychology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Outcome Assessment, Health Care/*statistics & numerical data
MH  - Personality Inventory/*statistics & numerical data
MH  - Psychometrics/statistics & numerical data
MH  - Quality of Life/psychology
MH  - Reproducibility of Results
EDAT- 2004/03/09 05:00
MHDA- 2004/04/20 05:00
CRDT- 2004/03/09 05:00
PHST- 2004/03/09 05:00 [pubmed]
PHST- 2004/04/20 05:00 [medline]
PHST- 2004/03/09 05:00 [entrez]
AID - 10.4088/jcp.v65n0204 [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2004 Feb;65(2):163-8. doi: 10.4088/jcp.v65n0204.