Major depressive disorder monitoring response to therapy
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Overview
Various definitions have been proposed for a response (Reliable Change Index (RCI)) and a remission to treatment.
- PHQ-9 score of ≤9 combined with improvement of 50% (the original definition)[1]
- A 30% reduction in a score[2].
- A 50% reduction in a score[3].
- Responsiveness statistic of Guyatt is the mean change divided by the square root of 2 x mean square error[4][5]
- The "response mean (difference of mean scores at 2 assessment points divided by standard deviation of score changes)...to compute the 95% confidence intervals of the standardized response means"[5][6]
- One standard error of measurement (SEM) of Wyrich[7][6]
- Jacobson has suggested[8]:
- "The level of functioning subsequent to therapy should fall outside the range of the dysfunctional population, where range is denned as extending to two standard deviations beyond (in the direction of functionality) the mean for that population."
- "The level of functioning subsequent to therapy should fall within the range of the functional or normal population, where range is defined as within two standard deviations of the mean of that population."
- "The level of functioning subsequent to therapy places that client closer to the mean of the functional population than it does to the mean of the dysfunctional population."[9]
References
- ↑ Kroenke K, Spitzer RL, Williams JB (2001). "The PHQ-9: validity of a brief depression severity measure". J Gen Intern Med. 16 (9): 606–13. doi:10.1046/j.1525-1497.2001.016009606.x. PMC 1495268. PMID 11556941.
- ↑ Ramsay JR (2017). "Assessment and monitoring of treatment response in adult ADHD patients: current perspectives". Neuropsychiatr Dis Treat. 13: 221–232. doi:10.2147/NDT.S104706. PMC 5291336. PMID 28184164.
- ↑ Gaynes BN, Rush AJ, Trivedi MH, Wisniewski SR, Balasubramani GK, McGrath PJ; et al. (2008). "Primary versus specialty care outcomes for depressed outpatients managed with measurement-based care: results from STAR*D". J Gen Intern Med. 23 (5): 551–60. doi:10.1007/s11606-008-0522-3. PMC 2324144. PMID 18247097.
- ↑ Guyatt GH, Townsend M, Berman LB, Keller JL (1987). "A comparison of Likert and visual analogue scales for measuring change in function". J Chronic Dis. 40 (12): 1129–33. doi:10.1016/0021-9681(87)90080-4. PMID 3680471.
- ↑ 5.0 5.1 Wright JG, Young NL (1997). "A comparison of different indices of responsiveness". J Clin Epidemiol. 50 (3): 239–46. doi:10.1016/s0895-4356(96)00373-3. PMID 9120522.
- ↑ 6.0 6.1 Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K (2004). "Monitoring depression treatment outcomes with the patient health questionnaire-9". Med Care. 42 (12): 1194–201. doi:10.1097/00005650-200412000-00006. PMID 15550799.
- ↑ Wyrwich KW, Tierney WM, Wolinsky FD (1999). "Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life". J Clin Epidemiol. 52 (9): 861–73. doi:10.1016/s0895-4356(99)00071-2. PMID 10529027.
- ↑ Jacobson NS, Truax P (1991). "Clinical significance: a statistical approach to defining meaningful change in psychotherapy research". J Consult Clin Psychol. 59 (1): 12–9. doi:10.1037//0022-006x.59.1.12. PMID 2002127.
- ↑ McMillan D, Gilbody S, Richards D (2010). "Defining successful treatment outcome in depression using the PHQ-9: a comparison of methods". J Affect Disord. 127 (1–3): 122–9. doi:10.1016/j.jad.2010.04.030. PMID 20569992.