Response and remission criteria in major depression - A validation of current practice

Remission and response were suggested as the most relevant outcome criteria for the treatment of depression There is still marked uncertainty as to what cut-offs should be used on current depression rating scales The goal of the present study was to compare the validity of different HAMD MADRS and BDI cut offs for response and remission The naturalistic prospective study was performed in 12 psychiatric hospitals in Germany All evaluable patient (n = 846) were hospitalized and had to meet DSM-IV criteria for major depressive disorder Biweekly ratings were assessed using HAMD-21 MADRS and BDI A CGI-S score of 1 and a CGI-I score of at least 2 was used as the primary comparative measure of remission and response respectively A HAMD-21 cut-off <= 7 (AUC 0 92) HAMD-17 cut-of <= 6 (AUC 0 90) MADRS cut-off <= 7 (AUC 0 94) and BDI cut-off <= 12 (AUC 0 83) were associated with a maximum of specificity and sensitivity for defining remission A minimum decrease of 47% of the HAMD-21 (AUC 0 90) <= 57% for HAMD-17 (AUC 0 89) <= 46% for MADRS (0 91) and a decrease of 47% for the BDI baseline score (AUC 0 78) best corresponded CGI response criteria Our data largely confirmed currently used remission and response criteria in naturalistically treated patient (C) 2010 Elsevier Ltd All rights reserved