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Int J Psychiatry Med. 2015;50(4):383-97. doi: 10.1177/0091217415612734. Epub 2015 Nov 2.

Improving the assessment of depression remission with the Remission Evaluation and Mood Inventory Tool.

Author information

1
Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA aikensj@umich.edu.
2
Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
3
Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
4
Department of Family Medicine, University of Colorado Denver, Aurora, CO, USA.

Abstract

OBJECTIVE:

The Remission Evaluation and Mood Inventory Tool (REMIT) is a practical 5-item self-report measure of key positive mood states associated with recovering from depression, as distinct from depressive symptoms per se. The study goal was to identify a clinically useful threshold for interpreting REMIT responses in the context of mild to moderate depressive symptoms.

METHODS:

This was a secondary analysis of a cross-sectional dataset initially used to develop and validate the REMIT. Primary care patients being treated for depressive symptoms of either mild or moderate severity (n = 247 and 240, respectively) rated their perceived degree of depression remission prior to completing the Patient Health Questionnaire-8 (PHQ-8) and the REMIT. We summed the totals of the latter two measures to form the PHQ + REMIT index.

RESULTS:

Receiver Operating Characteristics analysis indicated that the PHQ + REMIT threshold ≥ 13 was associated with good sensitivity (92%) and acceptable specificity (43%) to the absence of patient-perceived remission. In contrast, the PHQ had only 21% specificity at this sensitivity level. Area under the curve was 0.815 (95% C.I.: 0.765-0.865), which was significantly greater than that of the PHQ-8 alone (area under the curve = 0.745, 95% C.I.: 0.691-0.805, p(diff) = 0.0002). Threshold performance was unaffected by adjustment for demographic characteristics and variation in remission percentage. Compared with standard symptom-based classification, using the REMIT reclassified 27% of mildly symptomatic patients as remitted.

CONCLUSIONS:

Using the REMIT with patients who have mild to moderate depressive symptoms improves the assessment of patient-perceived remission, which is indicated by a summed PHQ + REMIT index of less than 13. Longitudinal research is needed to test whether this broadened patient-centered approach to assessing remission improves clinical decision making and long-term outcomes.

KEYWORDS:

Depression; diagnosis; mental health; psychological assessment

PMID:
26526397
DOI:
10.1177/0091217415612734
[Indexed for MEDLINE]

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