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    Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

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    Authors
    Dunlop, Boadie W.
    Li, Thomas
    Kornstein, Susan G.
    Friedman, Edward S.
    Rothschild, Anthony J.
    Pedersen, Ronald D.
    Ninan, Philip T.
    Keller, Martin B.
    Trivedi, Madhukar H.
    UMass Chan Affiliations
    Department of Psychiatry
    Document Type
    Journal Article
    Publication Date
    2011-01-12
    Keywords
    Depressive Disorder, Major
    Psychiatric Status Rating Scales
    Diagnostic Self Evaluation
    Treatment Outcome
    Psychiatry
    
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    Link to Full Text
    http://dx.doi.org/10.1016/j.jpsychires.2010.04.032
    Abstract
    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician ("concordant patients") were defined as having a standardized patient-rated Inventory of Depressive Symptoms-Self Report (IDS-SR) score minus standardized clinician-rated Hamilton Rating Scale for Depression (HAM-D) score <1 SD from mean. Non-concordant patients>("underrating patients" [-1 SD], "overrating patients" [+1 SD]) were identified. Cohorts were compared for remission and response on the HAM-D, Clinician Global Impression--Severity (CGI-S), and IDS-SR during acute and continuation therapy and time to recurrence during maintenance therapy. During acute treatment female patients were more likely to overrate their depression severity compared to the clinician; older age predicted overrating during continuation treatment. Overrating patients had a slower onset of response on the HAM-D during acute treatment (P=0.004). There were no differences between cohorts for remission or response on the HAM-D or CGI-S. Overrating patients at week 10 had lower remission and response rates on the IDS-SR during continuation therapy (32% and 50%, respectively; P
    Source
    J Psychiatr Res. 2011 Jan;45(1):96-103. Epub 2010 Jun 2. Link to article on publisher's site
    DOI
    10.1016/j.jpsychires.2010.04.032
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/45919
    PubMed ID
    20537348
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jpsychires.2010.04.032
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