title: Assessing full remission.
abstract: The 17-item Hamilton Rating Scale for Depression (HAM-D17) has been used for 4 decades as the "gold standard" instrument to assess the severity of depression and response to therapy in clinical research. The clinical utility of the HAM-D17 is hampered, in part, by the length of time required to administer the interview and by concern about a lack of inter-rater reliability. Several groups have developed shorter versions of the HAM-D17 for use in clinical practice. However, despite extensive research highlighting the importance of achieving full remission in minimizing the risk of relapse and recurrence, these shortened questionnaires have not been validated for the task of distinguishing between remission and response. A shortened form of the HAM-D17 with cut-off scores for full remission would offer a useful tool that physicians could readily employ in clinical practice. On the basis of the responses of a sample of 292 patients with major depression who received standard clinical treatment at a tertiary university affiliated hospital (Depression Clinic, Centre for Addiction and Mental Health, Toronto Ont.) we derived a shortened version of the HAM-D. Seven items with the greatest frequency of occurrence and sensitivity to change with treatment were identified and designated as the Toronto HAM-D7. A score of 3 or less on the Toronto HAM-D7 was found to correlate with the 17-item HAM-D definition of full remission (i.e., score of 7 or less).
authors.affiliation: Mood and Anxiety Disorders Program, Department of Psychiatry, University of Toronto, Toronto, Ont. roger_mcintyre@camh.net
authors.forename: Roger
authors.initials: R
authors.lastname: McIntyre
authors.forename: Sidney
authors.initials: S
authors.lastname: Kennedy
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
authors.forename: David
authors.initials: D
authors.lastname: Bakish
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012074:Remission Induction; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents