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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by River1924 on January 12, 2006, at 1:34:27
NEW YORK (Reuters Health) Jan 11 - More than merely relief from negative symptoms, patients being treated for depression hope for positive mental health and a return to normal functioning -- as measures of successful remission -- according to a report in the January 2006 issue of the American Journal of Psychiatry.
Antidepressant efficacy trials often rely on measures of symptom severity such as the HAM-D and Montgomery-Asberg Depression Rating Scale (MADRS), the authors explain, but normalization of function is rarely used to identify patients in remission.
Dr. Mark Zimmerman from Brown University School of Medicine, Providence, Rhode Island and colleagues surveyed 535 psychiatric outpatients with major depression as to what factors they considered important in defining remission from depression.
Among the 16 factors rated by the patients, the three most frequently judged to be very important in determining remission included the presence of features of positive mental health such as optimism and self-confidence; a return to one's usual, normal self; and a return to usual level of functioning, the authors report.
"The results of the present study suggest that depressed patients consider symptom resolution as only one factor in determining the state of remission," the investigators conclude. "In addition, patients indicated that the presence of positive features of mental health such as optimism, vigor, and self-confidence was a better indicator of remission than the absence of the symptoms of depression."
"Consequently," the authors add, "we recommend that studies comparing the respective validity of alternative conceptualizations of remission focus on prognosis."
"It is important to conduct a systematic and comprehensive evaluation of how a patient is feeling," Dr. Zimmerman told Reuters Health. "By systematic, I believe that standardized instruments should be incorporated into clinical practice. By comprehensive, I mean that these assessments should go beyond symptom assessments."
Also, he said, "We are trying to get access to databases that have been collected by pharmaceutical companies to examine whether different cutoffs on the Hamilton will provide a more valid definition of remission by virtue of the ability to predict future relapse."
Am J Psychiatry 2006;163:148-150.
Posted by blueberry on January 12, 2006, at 5:38:29
In reply to DUH? IT TAKES A STUDY. DOES IT?, posted by River1924 on January 12, 2006, at 1:34:27
Duh is right. I mean, most clinical studies measure response as a 50% reduction of symptoms. Well, that means patients who do respond and are considered successful treatments are still 50% ill! Duh. And remission rates are in the 20% to 30% range. But even in those so called remission patients, there are often still some negative features that still linger.
I have found that most medications do indeed get me out of the crying sobbing depressed phase, but still leave me in a considerably crippled state, far less functional than a normal healthy person.
Posted by Glydin on January 12, 2006, at 11:45:57
In reply to DUH? IT TAKES A STUDY. DOES IT?, posted by River1924 on January 12, 2006, at 1:34:27
I did have to laugh….
It does happen in other areas of healthcare.
I knew of a grant-fueled study to prove a sugar solution on a pacifier was comforting to neonates. Tons of mothers for years upon years have utilized a “Sugar T*t” to soothe infants. It took big grant money and countless hours of data collection to prove this works.
When I see studies that appear to be just common sense, I refer to them as: “ST” proof. We seem to be a society that requires the scientific method for everything because we must have PROOF.
Posted by ed_uk on January 12, 2006, at 13:45:58
In reply to Re: DUH? IT TAKES A STUDY. DOES IT?, posted by Glydin on January 12, 2006, at 11:45:57
Well what do ya know!
Ed
Posted by 4WD on January 12, 2006, at 20:49:01
In reply to Re: DUH? IT TAKES A STUDY. DOES IT?, posted by blueberry on January 12, 2006, at 5:38:29
> Duh is right. I mean, most clinical studies measure response as a 50% reduction of symptoms. Well, that means patients who do respond and are considered successful treatments are still 50% ill! Duh. And remission rates are in the 20% to 30% range. But even in those so called remission patients, there are often still some negative features that still linger.
>
> I have found that most medications do indeed get me out of the crying sobbing depressed phase, but still leave me in a considerably crippled state, far less functional than a normal healthy person.Exactly. You don't want to commit suicide anymore. You don't want to do anything else either, though.
Marsha
Posted by Phillipa on January 12, 2006, at 21:33:28
In reply to Re: DUH? IT TAKES A STUDY. DOES IT? » blueberry, posted by 4WD on January 12, 2006, at 20:49:01
that's the truth! Fondly, Phillipa
This is the end of the thread.
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