Abstract:
:More than a decade ago, a consensus panel recommended that remission be defined on the 17-item version of the Hamilton Rating Scale for Depression (HAM-D) as a cutoff of less than 7. Recently, some investigators have suggested that this threshold to define remission may be too high. If true, this means that heterogeneity exists within the group of treatment remitters accounting for variance in psychosocial function and relapse risk. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we examined whether there is heterogeneity within the group of patients that are typically classified as remitters. Three hundred three depressed psychiatric outpatients were rated on the Standardized Clinical Outcome Rating for Depression, an index of Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition remission status, and the 17-item HAM-D. Approximately half of the patients completed a measure of psychosocial impairment. Treatment responders were divided into 2 groups, remitters (HAM-D < or =7) and nonremitters (HAM-D > or =8). The treatment remitters were further subdivided into 2 groups, remitters with and without mild residual symptoms (HAM-D 3-7 vs 0-2). We refer to these 3 nonoverlapping groups as responders, partial remitters (ie, remitters with mild residual symptoms), and full remitters (remitters without residual symptoms). Responders scored statistically significantly higher, indicating greater psychosocial impairment, than the entire group of remitters, and the partial remitters scored significantly higher than the full remitters. Among the responders, the correlation between remission status and functioning was -.49 (P < .01). Among the remitters, the correlation between residual symptom status and functioning was nearly as high (-.42, P < .05). These results suggest that there is as much heterogeneity among patients who are typically considered to be in remission as there is among responders. This supports recommendations to lower the cutoff on the HAM-D to define remission.
journal_name
Compr Psychiatryjournal_title
Comprehensive psychiatryauthors
Zimmerman M,Posternak MA,Chelminski Idoi
10.1016/j.comppsych.2006.10.005subject
Has Abstractpub_date
2007-03-01 00:00:00pages
113-7issue
2eissn
0010-440Xissn
1532-8384pii
S0010-440X(06)00123-4journal_volume
48pub_type
杂志文章abstract::Combat exposure is associated with increased risk of psychiatric and substance use disorders in veterans. However, it is not known whether combat exposure independently increases risk for these disorders or whether this association is accounted for by genetic vulnerability common to posttraumatic stress disorder (PTSD...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2007.11.001
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:Bipolar disorders (BDs) are often not recognised with potentially drastic consequences for the individuals and their families. In clinical practice self-reports can be used to screen to enhance recognition. We therefore present a systematic review of the screening properties for the Hypomania Checklist (HCL-3...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,评审
doi:10.1016/j.comppsych.2014.03.002
更新日期:2014-07-01 00:00:00
abstract::The differentiation of three types of panic attacks is proposed to be significant for understanding the course and etiology of panic and other psychiatric disorders and physical illnesses. The present investigation is based on longitudinal data from the Epidemiologic Catchment Area (ECA) Study of 1980 to 1981 and its ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/s0010-440x(99)90092-5
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Males are more likely than females to die by all forms of violent death, including suicide. The primary purpose of the present study was to explore whether the gender difference in suicide rates is largely accounted for by males' general greater tendency to experience violent deaths. The current study examine...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2014.03.017
更新日期:2014-07-01 00:00:00
abstract::Sixty-four patients with borderline personality disorder (BPD) were followed up for a mean of 27 years. Outcome was assessed using the Diagnostic Interview for Borderlines, Revised (DIB-R); the Schedule for DSM-III-R Diagnosis (SCID); Global Assessment of Functioning (GAF); the Symptom Check List-90 (SCL-90); and the ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1053/comp.2001.26271
更新日期:2001-11-01 00:00:00
abstract::The history of the positive/negative terminology, as applied to psychiatric symptoms, can be divided into an early period of original meanings, a second one of French elaboration, and the current revival. This report addresses issues concerning the meaning, referent, and nature of the link between the positive and the...
journal_title:Comprehensive psychiatry
pub_type: 历史文章,杂志文章
doi:10.1016/0010-440x(91)90016-6
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVES:Despite inclusion of adolescent insanity-a concept proposed by Thomas Clouston in late XIX century-into the broader nosological entity of dementia praecox, the uniqueness of early psychosis is still discussed. The aim of the current study is the assessment of course and outcome in the large sample of early-o...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2014.03.013
更新日期:2014-07-01 00:00:00
abstract::Schizophrenia is present in all human populations with approximately the same incidence. Why does such illness persist given that it is associated with a reproductive disadvantage? What is the balancing advantage? A possible explanation is linked to human language. According to this hypothesis schizophrenia occurs as ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,评审
doi:10.1053/comp.2003.50003
更新日期:2003-01-01 00:00:00
abstract::The aim of this study was to examine the role of emotions like pity and anger in mediating the relationship between beliefs about the controllability of a mental illness, and the willingness to help someone with a mental illness. In particular, we tested the hypothesis that the effects of beliefs about controllability...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.comppsych.2012.11.004
更新日期:2013-07-01 00:00:00
abstract::We examined the prevalence and correlates of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) risk behaviors in a large sample of severely mentally ill (SMI) patients. Risk levels were correlated with demographic factors, diagnosis, symptom severity, trauma history, post-traumatic stress di...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1053/comp.2001.24576
更新日期:2001-07-01 00:00:00
abstract::We describe our experience with a case of folie à famille with role reversal, including the long-term course. In addition, the case reports published since 1974 were reviewed and an overview is given of the psychoanalytic and system theory concepts on the pathogenesis of induced psychotic disorder. The inductor often ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,评审
doi:10.1016/0010-440x(93)90056-a
更新日期:1993-03-01 00:00:00
abstract::Age-specific suicide rates in the United States between 1951 and 1988 were shown in cohort, cross-sectional, and age group formats. Despite considerable variation among women and younger and older men, suicide rates among 40- to 44-year-old men have remained stable. Since suicide is strongly influenced by psychosocial...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/s0010-440x(96)90039-5
更新日期:1996-05-01 00:00:00
abstract::The Axis I phenomenology of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder (BPD), 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder (APD), and 26 outpatients meeting DSM-III criteria for Dsythymic Disorder as wel...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/0010-440x(89)90067-9
更新日期:1989-03-01 00:00:00
abstract::Substance use disorders are associated with increased suicidal behavior. The suicidal behavior in patients without a history of illegal substance abuse, who consume benzodiazepines (BZDs) regularly in doses higher than those recommended, has not been previously studied. The aim of this study was to investigate the fac...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1053/comp.2002.35912
更新日期:2002-11-01 00:00:00
abstract::Lack of insight of patients with schizophrenia into various aspects of their illness and treatment is an important clinical issue. Poor insight has been reported to be associated with neurocognitive deficits, particularly in the frontal and parietal functions. The aim of this study was to examine relationships between...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2004.11.002
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Time of in-patient treatment and the first weeks after hospital discharge have repeatedly been described as periods of increased suicide risk. This study compared demographic, clinical and suicide related factors between in-patient, post-discharge and not recently hospitalized suicides. METHODS:Suicide data ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2016.05.003
更新日期:2016-08-01 00:00:00
abstract::The Defense Style Questionnaire (DSQ) assesses defensive behavior by empirically evaluating conscious derivatives of defense and coping mechanisms in everyday life. It was developed on the assumption that defenses can be ordered along a maturity-immaturity continuum and tend to group into clusters, or defensive styles...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2004.07.012
更新日期:2004-11-01 00:00:00
abstract::The question of what role genetic factors have in the transmission of suicidal behavior, in particular suicide itself, is discussed on the basis of five studies of an epidemiologically clearly defined region (the Province of Salzburg, Austria). The high percentage of suicide-positive family histories as compared with ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/0010-440x(90)90070-9
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Medical illnesses are highly comorbid with bipolar disorder, but their relationship to illness characteristics has not been previously delineated. METHODS:The incidence of 34 medical conditions and 6 poor prognosis factors (PPFs) was derived from answers to a questionnaire in over 900 outpatients with bipol...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2014.08.050
更新日期:2015-01-01 00:00:00
abstract::In this study, we aimed to determine the influence of various types of childhood trauma (CT) on cognitive functions in Chinese patients presented with schizophrenia. One hundred sixty-two patients were assessed with the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and Repeatable Battery for the Assessment of Neu...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2017.04.010
更新日期:2017-07-01 00:00:00
abstract::Our aim was to describe the clinical features of 35% CO2-induced panic attacks in patients with panic disorder (PD) (Diagnostic and Statistical Manual and Mental Disorders, Fourth Edition) and compare them with the last spontaneous panic attack in patients with PD who had not had a panic attack after the 35% CO2 chall...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.comppsych.2005.07.007
更新日期:2006-05-01 00:00:00
abstract::A number of studies have examined the relationships between aggression and various facets of the work environment. However, to our knowledge, the relationship between self-reported aggressive behaviors and corresponding employment histories has never been previously explored. Using a cross-sectional approach and a sel...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2012.06.005
更新日期:2013-01-01 00:00:00
abstract::Major depression forms the background of upwards of half of all suicides. Women are twice as likely as men to experience major depression, yet women are one fourth as likely as men to take their own lives. Current and past explanations of this paradox are built on androcentric assumptions that women are deficient in s...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章,评审
doi:10.1016/s0010-440x(98)90057-8
更新日期:1998-07-01 00:00:00
abstract::Until the 1850s, obsessive-compulsive phenomena were considered to be a variant of the old notion of insanity. Around this time they became a separate disease: first, as a member of the old class of the neuroses; then, briefly, as a variant of the newly formed notion of psychosis; and finally, as a neurosis proper (in...
journal_title:Comprehensive psychiatry
pub_type: 历史文章,杂志文章
doi:10.1016/0010-440x(89)90052-7
更新日期:1989-07-01 00:00:00
abstract::The purpose of the study was to identify psychiatric symptoms, neurological impairments, and situational factors associated with the emergence of violence and with its persistence. Psychiatric symptoms were assessed in newly admitted physically assaultive psychiatric patients and nonviolent controls. Patients were tha...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/s0010-440x(97)90031-6
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Previous research has documented increased incidence of insecure attachment and theory of mind (ToM) deficits in individuals experiencing psychotic disorders. ToM has been theorized as a possible mediator of the relation between attachment and psychosis (Korver-Nieberg et al., 2014). The current study sought...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2017.07.002
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Given the high rates of suicide in the adolescent population and the reluctance of this population to seek help, developing proactive and effective strategies to timely detect individuals at high risk for suicide in non-clinical contexts is a worldwide recognized need. A series of brief self-report questionn...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2018.11.002
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Little is known about the prevalence and incidence of traditional eating disorders (EDs, e.g., anorexia nervosa (AN), bulimia nervosa and binge eating disorder (BED)) in individuals with childhood onset neuropsychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum ...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2015.12.009
更新日期:2016-04-01 00:00:00
abstract::The primary purpose of this study was to assess the prevalence of major psychiatric disorders in human immunodeficiency virus-positive (HIV+) men with acquired immune deficiency syndrome (AIDS)-defining conditions. Secondary goals were to identify correlates of distress and psychopathology, and to determine whether th...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/s0010-440x(97)90067-5
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Social support and sense of mastery are considered important resources in coping both with serious mental illness (SMI) and with motherhood-related challenges. However, their interactive effects on the parental stress of mothers with SMI are not clear. METHODS:Scales assessing parental distress, social supp...
journal_title:Comprehensive psychiatry
pub_type: 杂志文章
doi:10.1016/j.comppsych.2018.08.015
更新日期:2018-11-01 00:00:00