The concept of recovery in major depression.
BACKGROUND
There is increasing literature on the unsatisfactory degree of remission that current therapeutic strategies yield in unipolar depression. The aims of this review were to survey the available literature on residual symptoms of depression, to introduce new targets for therapy and to outline a more stringent definition of recovery.


METHODS
Studies were identified by using MEDLINE (English language articles published from 1967 to June 2006; keywords: recovery, remission, residual symptoms, sequential treatment, drugs and psychotherapy, related to depressive disorder and depression) and a manual search of the literature and Index Medicus for the years 1960-2006.


RESULTS
Most patients report residual symptoms despite apparently successful treatment. Residual symptoms upon remission have a strong prognostic value. There appears to be a relationship between residual and prodromal symptomatology. The concept of recovery should involve psychological well-being.


CONCLUSIONS
Appraisal of subclinical symptomatology in depression has important implications for pathophysiological models of disease and relapse prevention. New therapeutic strategies for improving the level of remission, such as treatment on residual symptoms that progress to become prodromes of relapse, may yield more lasting benefits.
Fava
Giovanni A
GA
Ruini
Chiara
C
Belaise
Carlotta
C
D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D011379:Prognosis; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence
D000928:Antidepressive Agents