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Arch Gen Psychiatry. 1991 Sep;48(9):796-800.

The definition and operational criteria for treatment outcome of major depressive disorder. A review of the current research literature.

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  • 1Division of Clinical Research, National Institute of Mental Health, Rockville, Md. 20857.


A review of research articles published in nine journals over a 2-year period was conducted to determine how critical changes in the clinical course of depressive disorder are defined in the research literature. These change points, labeled by terms such as response, recovery, and relapse, are critical for evaluation and communication of study results. The review focused on studies of unipolar depression that used a criterion-based diagnostic system and involved some form of therapeutic maneuver. The review showed significant inconsistency in the labeling and definition of change points and indicated the need for more precise conceptual definitions and operational criteria to enhance comparison, generalization, and application of results from clinical studies of depression.

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