Frank E, Prien RF, Jarrett RB, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991.
Rush AJ, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006.
American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder.
Remission is the resolution of a depressive episode to a near-normal level of symptoms. Operationally, remission is often defined as a PHQ-9 score below 5 or a comparable threshold on a clinician-rated scale. Recovery is the term for sustained remission, usually for at least four to six months.
Why is full remission the goal, not just response?+
Response means a meaningful reduction in symptoms (often a 50 percent drop on a rating scale). Remission means symptoms are essentially gone. Patients who reach remission have lower relapse rates and better functioning at work, school, and in relationships than patients who only reach response.
How often do patients reach remission?+
About one in three patients with major depressive disorder reach remission on the first medication tried, and about half show a meaningful response (STAR*D, 2006). Most patients who don't remit on the first medication respond to a switch, a dose change, or an addition. With persistent care, most people reach remission.
How long should treatment continue after remission?+
After a first episode, most clinicians continue antidepressants for six to twelve months after symptoms resolve and then reassess. After multiple episodes, longer maintenance is often recommended. Stopping is a clinician-supervised decision because abrupt discontinuation increases the risk of relapse.
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