(PSYCHIATRIC TIMES) - Depression is one of the most significant direct and indirect threats to health and wellness. The negative impact of depression on work, productivity, interpersonal relationships, leisure activities, and a sense of well-being and enjoyment of life cannot be emphasized enough.
With the expansion of treatment choices in both psychotherapy and pharmacotherapy, it is becoming increasingly important to monitor patients’ progress using both measurement tools and clinical judgment. Measuring improvement and deterioration is paramount in evaluating the need for changing, adding, or maintaining therapeutic interventions. Measuring progress is becoming a clinical practice reality and is no longer limited to research methodology. However, the past decades have witnessed a sole emphasis on one dimension of outcome measurement—symptom severity.
Time-limited pharmaceutical studies propagated the notion that improvement is somehow equivalent to response, which is defined as a 50% reduction in symptom severity. Not only was symptom remission neglected, but more important, the mere definition of a psychiatric disorder—impairment of social, occupational, and other important areas of functioning—was abandoned. Moreover, quality-of-life assessment was seldom mentioned (it has only gained more attention recently).
Comprehensive outcome assessment and measurement emphasize the importance of incorporating the 3 dimensions—symptom severity, functioning, and quality of life—into both clinical and research outcome assessments. This article emphasizes this multidimensional approach and reviews practical instruments that can be incorporated into daily practice.
To define recovery, a medical analogy is used: imagine a patient who broke her arm in an unfortunate fall. The recovery process is expected to go through 3 stages:
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