title: Clinical differences between early and late remission in depressive patients.
abstract: OBJECTIVE
  Predicting treatment outcome at an early stage is clinically relevant. The main objectives are: to compare rates of remission after acute and continuation phase treatment and to determine the most common residual symptoms among remitted patients; to compare the residual symptoms in early and late remitted and to identify factors that predict early or faster remission.
  
  
  METHODS
  It is a prospective, naturalistic, multicenter, and nationwide epidemiological study of 1595 depressive outpatients. Severity of depressive symptoms was assessed with the Hamilton Depression Rating Scale (HDRS) and the Self Rated Inventory of Depressive Symptomatology (IDS-SR(30)). Assessments were carried out after 6-8 weeks of antidepressant treatment and after 14-20 weeks of continuation treatment. Early remitters were defined with an IDS-SR(30) score ≤ 14 at first and second assessment. Late remitters were defined as those scoring IDS-SR(30) >14 at first and IDS-SR(30) score ≤ 14 at second assessment.
  
  
  RESULTS
  140 subjects (8.8%) were in remission after 6-8 weeks of antidepressant treatment and 862 remitted (59%) after 16-20 weeks of treatment. The mean number of residual symptoms is significantly higher among patients who remit later. Greater differences between early and late remitters were found in the following symptoms: feeling sad, reactivity of mood, interpersonal sensitivity and pleasure/enjoyment. Multivariate analysis showed that only comorbid anxiety disorder is significantly associated with late remission.
  
  
  CONCLUSIONS
  Early remitted patients have a better "quality" of remission. Late remission is associated with residual symptoms more related to core depressive symptoms. Residual symptoms in early remitted patients may constitute a new target for the treatment of depression.
authors.affiliation: Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain. mroca@uib.es
authors.forename: Miquel
authors.initials: M
authors.lastname: Roca
authors.forename: Mauro
authors.initials: M
authors.lastname: García-Toro
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
authors.forename: Margalida
authors.initials: M
authors.lastname: Vives
authors.forename: Silvia
authors.initials: S
authors.lastname: Armengol
authors.forename: Margarita
authors.initials: M
authors.lastname: García-García
authors.forename: David
authors.initials: D
authors.lastname: Asensio
authors.forename: Margalida
authors.initials: M
authors.lastname: Gili
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003863:Depression; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D004644:Emotions; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents