Functional outcomes in MDD: established and emerging assessment tools.
Currently, the primary efficacy measures for antidepressant clinical trials predominantly assess changes in mood symptoms in patients with major depressive disorder (MDD). When considering treatment options, however, patients and clinicians value improvement in function in important life domains as highly as symptom reduction. MDD patients report that they consider a return to normal functioning an important indicator of remission from depressive episodes. Indeed, many researchers now regard assessment of both mood symptoms and functional outcomes essential to measuring treatment-related improvement and remission from MDD. However, function is a very broad concept. Investigators must consider multiple issues in designing or selecting an instrument that measures function adequately and appropriately in their particular study population. The assessment tool should include dimensions of functioning that are relevant and likely to improve with the treatment, and the instrument should have demonstrated reliability and validity, good discrimination among patients, and sensitivity to meaningful improvement in functioning. The inclusion of well-chosen functional outcome measures in clinical trials will improve the assessment of impairment and improvement with treatment, and provide patients and clinicians with important information about the efficacy of antidepressant treatments.
Endicott
Jean
J
Department of Psychiatry, Columbia University, NYSPI-Unit 123, 1051 Riverside Dr, New York, NY 10032, USA. je10@columbia.edu
Dorries
Kathleen M
KM
D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D006801:Humans; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome