title: Broader conceptualization of remission assessed by the remission from depression questionnaire and its association with symptomatic remission: a prospective, multicenter, observational study.
abstract: BACKGROUND
  Goals of treating major depressive disorder (MDD) include achieving remission and avoiding relapse. It is possible that patients may have a broader view of remission than what is captured via clinician-rated scales. This patient perspective may, in turn, have an impact on treatment outcomes.
  
  
  METHODS
  The association between a broader conceptualization of remission, based on the Remission from Depression Questionnaire (RDQ) score at baseline, and being in symptomatic remission after 6 months was evaluated in subjects (N = 613) with MDD in symptomatic remission at baseline (17-item Hamilton Rating Scale for Depression [HAMD-17] ≤7). Specific aspects of depression were assessed from physician and patient perspectives as secondary endpoints. A backwards selection strategy was used to statistically model remission status and determine association of factors with potential to influence remission.
  
  
  RESULTS
  At month 6, after adjustment for baseline HAMD-17 score, there was no association between baseline RDQ score and symptomatic remission status (HAMD-17), relapse, composite remission status, healthcare resource utilization, or quality of life. There was no association between functional impairment scores at baseline (Sheehan Disability Scale and Social and Occupational Functioning Assessment Scale) and symptomatic remission status (HAMD-17) at month 6.
  
  
  CONCLUSIONS
  This study indicates that RDQ-constructs are independent from symptomatic remission. Symptom severity at study entry appeared to be the only significant predictor of eventual relapse during the 6-month follow-up period. However, our results also suggest that the current definition of remission that is based on symptom reduction should be further elaborated and that alternative or additional definitions should be considered in determining remission.
authors.affiliation: Department of Medical Neurosciences, Lilly Research Laboratories, Eli Lilly Canada Inc., 3650 Danforth Avenue, Toronto, ON, Canada. montoya_alonso@lilly.com.
authors.forename: Alonso
authors.initials: A
authors.lastname: Montoya
authors.affiliation: Department of Global Statistical Sciences, Eli Lilly and Company, Werner-Reimers-Straße 2, 61352, Bad Homburg vor der Höhe, Germany.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Lebrec
authors.affiliation: Department of Clinical Development, Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK.
authors.forename: Karen Mary
authors.initials: KM
authors.lastname: Keane
authors.affiliation: Department of Clinical Research, Eli Lilly and Company, Avenida de la Industria, 30, 28108, Alcobendas, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Fregenal
authors.affiliation: Department of Clinical Research, Eli Lilly and Company, Avenida de la Industria, 30, 28108, Alcobendas, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciudad
authors.affiliation: Department of Psychiatry, University of Sevilla, Calle San Fernando, 4, 41004, Sevilla, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Moríñigo
authors.affiliation: Department of Psychiatry, Hospital Universitario 12 de Octubre and CIBERSAM, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Agüera-Ortiz
authors.affiliation: Department of Clinical Research, Eli Lilly and Company, Avenida de la Industria, 30, 28108, Alcobendas, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Romera
authors.affiliation: Department of Psychiatry, Universidad San Pablo CEU, Madrid, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Gilaberte
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, 146 West River Street, Providence, 02904, Rhode Island, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*; D012074:Remission Induction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Hamilton rating scale for depression; Major depressive disorder; Remission; Remission from depression questionnaire