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Depressed patients’ view of remission likely different from clinicians

Patients with major depressive disorder often define remission from depression differently from clinicians, according to researchers from Brown University who designed a new questionnaire to measure remission status. The researchers said although clinicians assess remission based on symptoms, patients are more inclined to measure treatment success by factors such as life satisfaction and a sense of well-being.

“Current standards for treating major depressive disorder recommend that achieving remission should be considered the principal goal of treatment,” study researcher Mark Zimmerman, MD, said in a press release. “But recent studies have shown that patients and clinicians view remission very differently. To determine the best approach to achieving a level of remission satisfactory to the patient, we developed the Remission from Depression Questionnaire to measure the components of depression that patients feel are most important.”

Unlike other clinical assessments that take only recent symptom presence into account, such as the Quick Inventory of Depressive Symptomatology (QIDS), the Remission from Depression Questionnaire (RDQ) assesses a broader range of criteria reported by patients to be important in determining their own remission status. Besides assessing depressive symptoms, the RDQ also measures factors such as positive mental health, coping ability, functioning, life satisfaction and a general sense of well-being.

Zimmerman and colleagues conducted two studies to test the reliability and validity of the RDQ. The first study involved 100 outpatients being treated for major depression, and the second study included 274 outpatients being treated for the same disorder. Slightly less than 40% of all patients considered themselves to be in remission at the time of evaluation.

None of the items measured by the RDQ was represented by less than 25% of remitted patients. Remitted patients scored significantly lower on the RDQ subscales vs. patients who did not consider themselves to be in remission (P<.001).

According to the researchers, symptom-based assessments do not accurately represent depressed patients’ perceptions of remission.

“More work must be done to broaden the definition of remission,” Zimmerman said. “Our patients need to feel supported, they need to feel confident about their remission. Therefore, it’s imperative that clinicians and patients work more closely together to more clearly define remission in order to achieve the best outcomes for these patients. If some of the symptoms appear to be alleviated, but the patient is still suffering from a poor sense of well-being and low life satisfaction, then there is still more work to do.”

Disclosure: The researchers reported no relevant financial disclosures.