title: Measuring depressive symptoms in the naturalistic primary-care setting.
abstract: BACKGROUND
  The majority of individuals with major depressive disorder are diagnosed and treated in the primary-care setting. A quantifiable critical objective in the management of depression is to achieve and sustain full symptomatic remission. The HAMD-7 is a depression metric validated in both tertiary and primary-care settings.
  
  
  METHODS
  Herein, we further characterise the psychometric properties of the HAMD-7 in depressed patients treated in primary-care settings. Several cut-scores were evaluated for maximum agreement; diagnostic efficacy statistics with the original HAMD-7 items were also evaluated. We compared performance of the HAMD-7 in primary care to a previously characterised tertiary sample.
  
  
  RESULTS
  The depressive symptoms most frequently endorsed (>or=70%) and most sensitive to change during antidepressant treatment in depressed primary-care patients were depressed mood, guilt, work and activities, psychic and somatic anxiety and fatigue.
  
  
  CONCLUSIONS
  This is a post hoc analysis of a primary-care database; assumptions regarding the definition of symptomatic remission in depression affect interpretation.
  
  
  CONCLUSIONS
  Measurement-based care with the HAMD-7 quantifies the severity of commonly reported depressive items and their responsivity to treatment. The HAMD-7, inclusive of the suicide item, is capable of tracking symptom progress, with a validated remission cut-score.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, ON, Canada. roger.mcintyre@uhn.on.ca
authors.forename: R S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: J Z
authors.initials: JZ
authors.lastname: Konarski
authors.forename: S H
authors.initials: SH
authors.lastname: Kennedy
authors.forename: S E
authors.initials: SE
authors.lastname: Dickens
authors.forename: R M
authors.initials: RM
authors.lastname: Bagby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000145:classification* / Q000188:drug therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents