Defining remission by cut off score on the MADRS: selecting the optimal value.
BACKGROUND
Remission from major depression may be conceptualised in terms of a cut-off score on an appropriate rating scale. Candidate values proposed hitherto have not been directly validated.


METHODS
The relationship between The Clinical Global Impression Scale for Severity (CGI-S) and the Montgomery-Asberg Depression Rating Scale (MADRS) was explored in 684 major depressed patients (1114 observations). The value on the MADRS which had greatest concordance with remission, as defined by the CGI-S, was computed using two models. Concordance between clinician and patient judgements of global illness were also compared.


CONCLUSIONS
The two models yielded optimal definitions of remission of <9 and <10 on the MADRS. Either value offers a workable operationalisation of remission and there is little to choose between them.


CONCLUSIONS
The data confirm that MADRS <10 should provide the clinician with a valid, and reasonably objectifiable, target for remission
Department of Psychiatry, QEII Hospital, Hertfordshire AL7 4HQ, Welwyn Garden City, UK. c.l.hawley@herts.ac.uk
C J
CJ
Hawley
T M
TM
Gale
T
T
Sivakumaran
D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012075:Remission, Spontaneous; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires