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Journal Article•DOI•

The International Society for Bipolar Disorders (ISBD) Task Force report on the nomenclature of course and outcome in bipolar disorders

Mauricio Tohen1, Mauricio Tohen2, Ellen Frank3, Charles L. Bowden2, Francesc Colom4, S. Nassir Ghaemi5, Lakshmi N. Yatham6, Gin S Malhi7, Joseph R. Calabrese8, Willem A. Nolen9, Eduard Vieta4, Flávio Kapczinski10, Guy M. Goodwin11, Trisha Suppes12, Gary S. Sachs1, K. N. Roy Chengappa3, Heinz Grunze13, Philip B. Mitchell14, Shigenobu Kanba15, Michael Berk16 •
Harvard University1, University of Texas Health Science Center at San Antonio2, University of Pittsburgh3, University of Barcelona4, Tufts University5, University of British Columbia6, University of Sydney7, Case Western Reserve University8, University of Groningen9, Universidade Federal do Rio Grande do Sul10, Warneford Hospital11, Stanford University12, Newcastle University13, University of New South Wales14, Kyushu University15, University of Melbourne16
01 Aug 2009-Bipolar Disorders (WILEY)-Vol. 11, Iss: 5, pp 453-473
TL;DR: Determination and dissemination of a consensus nomenclature serve as the first step toward producing a validated and standardized system to define course and outcome in bipolar disorders in order to identify predictors of outcome and effects of treatment.
Abstract: Objectives: Via an international panel of experts, this paper attempts to document, review, interpret, and propose operational definitions used to describe the course of bipolar disorders for worldwide use, and to disseminate consensus opinion, supported by the existing literature, in order to better predict course and treatment outcomes. Methods: Under the auspices of the International Society for Bipolar Disorders, a task force was convened to examine, report, discuss, and integrate findings from the scientific literature related to observational and clinical trial studies in order to reach consensus and propose terminology describing course and outcome in bipolar disorders. Results: Consensus opinion was reached regarding the definition of nine terms (response, remission, recovery, relapse, recurrence, subsyndromal states, predominant polarity, switch, and functional outcome) commonly used to describe course and outcomes in bipolar disorders. Further studies are needed to validate the proposed definitions. Conclusion: Determination and dissemination of a consensus nomenclature serve as the first step toward producing a validated and standardized system to define course and outcome in bipolar disorders in order to identify predictors of outcome and effects of treatment. The task force acknowledges that there is limited validity to the proposed terms, as for the most part they represent a consensus opinion. These definitions need to be validated in existing databases and in future studies, and the primary goals of the task force are to stimulate research on the validity of proposed concepts and further standardize the technical nomenclature.
Citations
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Journal Article•DOI•
Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative.

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Kathleen R. Merikangas, Robert Jin, Jian-Ping He, Ronald C. Kessler, Sing Lee, Nancy A. Sampson, Maria Carmen Viana, Laura Helena Andrade, Chiyi Hu, Elie G. Karam, Maria Ladea, María Elena Medina-Mora, Yutaka Ono, Jose Posada-Villa, Rajesh Sagar, J. Elisabeth Wells, Zahari Zarkov 
07 Mar 2011-Archives of General Psychiatry
TL;DR: The uniform increases in clinical correlates, suicidal behavior, and comorbidity across each diagnostic category provide evidence for the validity of the concept of BPS.
Abstract: Context There is limited information on the prevalence and correlates of bipolar spectrum disorder in international population-based studies using common methods. Objectives To describe the prevalence, impact, patterns of comorbidity, and patterns of service utilization for bipolar spectrum disorder (BPS) in the World Health Organization World Mental Health Survey Initiative. Design, Setting, and Participants Cross-sectional, face-to-face, household surveys of 61 392 community adults in 11 countries in the Americas, Europe, and Asia assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, version 3.0, a fully structured, lay-administered psychiatric diagnostic interview. Main Outcome Measures Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) disorders, severity, and treatment. Results The aggregate lifetime prevalences were 0.6% for bipolar type I disorder (BP-I), 0.4% for BP-II, 1.4% for subthreshold BP, and 2.4% for BPS. Twelve-month prevalences were 0.4% for BP-I, 0.3% for BP-II, 0.8% for subthreshold BP, and 1.5% for BPS. Severity of both manic and depressive symptoms as well as suicidal behavior increased monotonically from subthreshold BP to BP-I. By contrast, role impairment was similar across BP subtypes. Symptom severity was greater for depressive episodes than manic episodes, with approximately 74.0% of respondents with depression and 50.9% of respondents with mania reporting severe role impairment. Three-quarters of those with BPS met criteria for at least 1 other disorder, with anxiety disorders (particularly panic attacks) being the most common comorbid condition. Less than half of those with lifetime BPS received mental health treatment, particularly in low-income countries, where only 25.2% reported contact with the mental health system. Conclusions Despite cross-site variation in the prevalence rates of BPS, the severity, impact, and patterns of comorbidity were remarkably similar internationally. The uniform increases in clinical correlates, suicidal behavior, and comorbidity across each diagnostic category provide evidence for the validity of the concept of BPS. Treatment needs for BPS are often unmet, particularly in low-income countries.

1,978 citations

Journal Article•DOI•
The International Society for bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders

[...]

Isabella Pacchiarotti1, David J. Bond1, Ross J. Baldessarini1, Willem A. Nolen1, Heinz Grunze1, Rasmus Wentzer Licht1, Robert M. Post1, Michael Berk1, Guy M. Goodwin1, Gary S. Sachs1, Leonardo Tondo1, Robert L. Findling1, Eric A. Youngstrom1, Mauricio Tohen1, Juan Undurraga1, Ana González-Pinto1, Joseph F. Goldberg1, Aysegul Yildiz1, Lori L. Altshuler1, Joseph R. Calabrese1, Philip B. Mitchell1, Michael E. Thase1, Athanasios Koukopoulos1, Francesc Colom1, Mark A. Frye1, Gin S Malhi1, Konstantinos N. Fountoulakis1, Gustavo H. Vázquez1, Roy H. Perlis1, Terence A. Ketter1, Frederick Cassidy1, Hagop S. Akiskal1, Jean-Michel Azorin1, Marc Valentí1, Diego Hidalgo Mazzei1, Beny Lafer1, Tadafumi Kato1, Lorenzo Mazzarini1, Anabel Martínez-Arán1, Gordon Parker1, Daniel Souery1, Ayşegül Özerdem1, Susan L. McElroy1, Paolo Girardi1, Michael Bauer1, Lakshmi N. Yatham1, Carlos A. Zarate1, Andrew A. Nierenberg1, Boris Birmaher1, Shigenobu Kanba1, Rif S. El-Mallakh1, Alessandro Serretti1, Zoltán Rihmer1, Allan H. Young1, Georgios D. Kotzalidis1, Glenda MacQueen1, Charles L. Bowden1, S. Nassir Ghaemi1, Carlos López-Jaramillo1, Janusz K. Rybakowski1, Kyooseob Ha1, Giulio Perugi1, Siegfried Kasper1, Jay D. Amsterdam1, Robert M. A. Hirschfeld1, Flávio Kapczinski1, Eduard Vieta1 •
Universidade Federal do Rio Grande do Sul1
01 Nov 2013-American Journal of Psychiatry
TL;DR: A consensus was reached on 12 statements on the use of antidepressants in bipolar disorder, and antidepressants should be prescribed only as an adjunct to mood-stabilizing medications.
Abstract: A task force report presents 12 recommendations for antidepressant use in bipolar disorder rated by at least 80% of International Society for Bipolar Disorders experts as essential or important.

475 citations

Additional excerpts

  • ...(59), to emphasize association without implying causality....

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Journal Article•DOI•
The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder.

[...]

Heinz Grunze1, Eduard Vieta2, Guy M. Goodwin3, Charles L. Bowden4, Rasmus Wentzer Licht5, Hans-Jürgen Möller1, Siegfried Kasper6 •
Ludwig Maximilian University of Munich1, University of Barcelona2, University of Oxford3, University of Texas Health Science Center at San Antonio4, Aarhus University Hospital5, Medical University of Vienna6
13 Mar 2013-World Journal of Biological Psychiatry
TL;DR: The purpose is to supply a systematic overview of all scientific evidence pertaining to the long-term treatment of bipolar disorder in adults, and lithium continues to be the substance with the broadest base of evidence across treatment scenarios.
Abstract: Objectives. These guidelines are based on a fi rst edition that was published in 2004, and have been edited and updated with the available scientifi c evidence up to October 2012. Their purpose is to supply a systematic overview of all scientifi c evidence pertaining to the long-term treatment of bipolar disorder in adults. Methods . Material used for these guidelines are based on a systematic literature search using various data bases. Their scientifi c rigor was categorised into six levels of evidence (A – F) and different grades of recommendation to ensure practicability were assigned. Results . Maintenance trial designs are complex and changed fundamentally over time; thus, it is not possible to give an overall recommendation for long-term treatment. Different scenarios have to be examined separately: Prevention of mania, depression, or an episode of any polarity, both in acute responders and in patients treated de novo . Treatment might differ in Bipolar II patients or Rapid cyclers, as well as in special subpopulations. We identifi ed several medications preventive against new manic episodes, whereas the current state of research into the prevention of new depressive episodes is less satisfactory. Lithium continues to be the substance with the broadest base of evidence across treatment scenarios. Conclusions . Although major advances have been made since the fi rst edition of this guideline in 2004, there are still areas of uncertainty, especially the prevention of depressive episodes and optimal long-term treatment of Bipolar II patients.

362 citations

Cites background from "The International Society for Bipol..."

  • ...…Bipolar Disorder (ISBD) suggested different time criteria for the continuation therapy phase, namely 4 weeks for recently manic and 8 weeks for recently depressed patients (Tohen et al 2009a), taking into account the different time lines for recovery from mania and depression (Solomon et al 2010)....

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  • ...Such a stringent definition could be operationalized in clinical studies by the absence of minimum DSM IV criteria (excluding duration of symptoms) for depression or mania, respectively, and the CGI-BP score (Tohen et al 2009a)....

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  • ...…syndromal recovery to a degree that symptom severity scores are below a predefined threshold in established clinician rating scales, e.g. a MADRS score of ≤ 10 in patients with a recent depressive episode (Hawley et al 2002), or a YMRS score of ≤ 12 in recently manic patients (Tohen et al 2009a)....

    [...]

Journal Article•DOI•
The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression.

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Heinz Grunze1, Eduard Vieta2, Guy M. Goodwin3, Charles L. Bowden4, Rasmus Wentzer Licht5, Hans-Jürgen Möller6, Siegfried Kasper7 •
Newcastle University1, University of Barcelona2, University of Oxford3, University of Texas Health Science Center at San Antonio4, Aarhus University Hospital5, Ludwig Maximilian University of Munich6, Medical University of Vienna7
25 Feb 2010-World Journal of Biological Psychiatry
TL;DR: Ten pharmacological monotherapies or combination treatments with at least limited positive evidence for efficacy in bipolar depression are identified, several of them still experimental and backed up only by a single study.
Abstract: Objectives. These guidelines are based on a first edition that was published in 2002, and have been edited and updated with the available scientific evidence until September 2009. Their purpose is ...

361 citations

Cites background from "The International Society for Bipol..."

  • ...…defi nition of switch, irrespectively its relation to treatment, hence it needs validation in prospective trials: a switch (i.e. the appearance of an episode of the opposite pole directly from/after the index episode) would be defi ned as occurring up to 8 weeks after remission (Tohen et al. 2009)....

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  • ...Traditionally, bipolar depression is considered to be more refractory than unipolar depression (Kupfer et al. 2000), with less favourable response to treatments, and the perceived risk of treatment emergent affective switches (TEAS; Tohen et al. 2009)....

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  • ...2000), with less favourable response to treatments, and the perceived risk of treatment emergent affective switches (TEAS; Tohen et al. 2009)....

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  • ...the appearance of an episode of the opposite pole directly from/after the index episode) would be defi ned as occurring up to 8 weeks after remission (Tohen et al. 2009)....

    [...]

Journal Article•DOI•
Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data: Consensus on Neovascular Age-Related Macular Degeneration Nomenclature Study Group

[...]

Richard F. Spaide, Glenn J. Jaffe1, David Sarraf2, K. Bailey Freund, Srinivas R. Sadda2, Giovanni Staurenghi, Nadia K. Waheed3, Usha Chakravarthy4, Philip J. Rosenfeld5, Frank G. Holz6, Eric H. Souied7, Salomon Y. Cohen, Giuseppe Querques8, Kyoko Ohno-Matsui9, David S. Boyer, Alain Gaudric7, Barbara A Blodi10, Caroline R. Baumal3, Xiaoxin Li11, Gabriel Coscas7, Alexander J. Brucker12, Lawrence J. Singerman13, Phil Luthert14, Steffen Schmitz-Valckenberg6, Ursula Schmidt-Erfurth, Hans E. Grossniklaus15, David J. Wilson16, Robyn H. Guymer17, Lawrence A. Yannuzzi, Emily Y. Chew18, Karl G. Csaky, Jordi Monés, Daniel Pauleikhoff, Ramin Tadayoni7, James G. Fujimoto19 •
Duke University1, University of California, Los Angeles2, Tufts University3, Queen's University Belfast4, University of Miami5, University of Bonn6, University of Paris7, Vita-Salute San Raffaele University8, Tokyo Medical and Dental University9, University of Wisconsin-Madison10, Peking University11, University of Pennsylvania12, Case Western Reserve University13, University College London14, Emory University15, Oregon Health & Science University16, University of Melbourne17, National Institutes of Health18, Massachusetts Institute of Technology19
01 May 2020-Ophthalmology
TL;DR: The study group suggests that the consensus standards outlined in this article be used in future reported studies of neovascular AMD and clinical practice.

339 citations

References
More filters
Journal Article•DOI•
An inventory for measuring depression

[...]

Aaron T. Beck, Clyde H. Ward, M. Mendelson, J. E. Mock, J. K. Erbaugh 
01 Jun 1961-Archives of General Psychiatry
TL;DR: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out and a wide variety of psychiatric rating scales have been developed.
Abstract: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations." Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15These have been well summarized in a review article by Lorr11on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific

35,176 citations

"The International Society for Bipol..." refers methods in this paper

  • ...The BDI-II does not include weight gain, but does otherwise include all other criterion symptom domains....

    [...]

  • ...nine-item self-reported Patient Health Questionnaire (PHQ-9) (24), the 16-item Quick Inventory of Depressive Symptomatology, available as a clinician rating (QIDS-C16) or self-report (QIDS-SIR), (25, 26), and the Beck Depression Inventory, Version II (BDI-II) (27, 28), a self-report....

    [...]

  • ...Rating scales that identify all nine criterion domains include the nine-item self-reported Patient Health Questionnaire (PHQ-9) (24), the 16-item Quick Inventory of Depressive Symptomatology, available as a clinician rating (QIDS-C16) or self-report (QIDS-SIR), (25, 26), and the Beck Depression Inventory, Version II (BDI-II) (27, 28), a self-report....

    [...]

Journal Article•DOI•
A rating scale for depression

[...]

Max Hamilton
01 Feb 1960-Journal of Neurology, Neurosurgery, and Psychiatry
TL;DR: The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.
Abstract: Types of Rating Scale The value of this one, and its limitations, can best be considered against its background, so it is useful to consider the limitations of the various rating scales extant. They can be classified into four groups, the first of which has been devised for use on normal subjects. Patients suffering from mental disorders score very highly on some of the variables and these high scores serve as a measure of their illness. Such scales can be very useful, but have two defects: many symptoms are not found in normal persons; and less obviously, but more important, there is a qualitative difference between symptoms of mental illness and normal variations of behaviour. The difference between the two is not a philosophical problem but a biological one. There is always a loss of function in illness, with impaired efficiency. Self-rating scales are popular because they are easy to administer. Aside from the notorious unreliability of self-assessment, such scales are of little use for semiliterate patients and are no use for seriously ill patients who are unable to deal with them. Many rating scales for behaviour have been devised for assessing the social adjustment of patients and their behaviour in the hospital ward. They are very useful for their purpose but give little or no information about symptoms. Finally, a number of scales have been devised specifically for rating symptoms of mental illness. They cover the whole range of symptoms, but such all-inclusiveness has its disadvantages. In the first place, it is extremely difficult to differentiate some symptoms, e.g., apathy, retardation, stupor. These three look alike, but they are quite different and appear in different settings. Other symptoms are difficult to define, except in terms of their settings, e.g., mild agitation and derealization. A more serious difficulty lies in the fallacy of naming. For example, the term "delusions" covers schizophrenic, depressive, hypochrondriacal, and paranoid delusions. They are all quite different and should be clearly distinguished. Another difficulty may be summarized by saying that the weights given to symptoms should not be linear. Thus, in schizophrenia, the amount of anxiety is of no importance, whereas in anxiety states it is fundamental. Again, a schizophrenic patient who has delusions is not necessarily worse than one who has not, but a depressive patient who has, is much worse. Finally, although rating scales are not used for making a diagnosis, they should have some relation to it. Thus the schizophrenic patients should have a high score on schizophrenia and comparatively small scores on other syndromes. In practice, this does not occur. The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type. It is used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information. The interviewer may, and should, use all information available to help him with his interview and in making the final assessment. The scale has undergone a number of changes since it was first tried out, and although there is room for further improvement, it will be found efficient and simple in use. It has been found to be of great practical value in assessing results of treatment.

29,488 citations

"The International Society for Bipol..." refers methods in this paper

  • ...A HAMD-17 score £ 7 corresponds to a MADRS score £ 9 (30) or a 30- item IDS-Clinician-Rated (IDS-C30) score £ 12, an IDS Self-Report (IDS-SIR) score £ 14 (30), or a QIDS-C16 or QIDS-SIR score £ 5 (25, 26)....

    [...]

  • ...For unipolar depression, response has typically been defined as a ‡ 50% reduction in pretreatment symptom severity using symptom rating scales such as the Hamilton Rating Scale for Depression (HAMD) (14), the Montgomery-Åsberg Depression Rating Scale (MADRS) (15), the Inventory for Depression Symptomatology (IDS) (16), and the Bipolar Depression Rating Scale (BDRS) (17)....

    [...]

  • ...The second issue is the imperative to develop rating scales that adequately assess some of the nuances of bipolar depression; the BDRS or the IDS, recently administered in clinical trials (35, 36), and the revision of the HAMD by Thase et al. (37) are examples of attempts to achieve this goal....

    [...]

  • ...For example, the HAMD-17 does not include oversleeping, weight and appetite increase, or impaired concentration ⁄decision making....

    [...]

  • ...Considering a score of 7 as an upper boundary for defining remission status with the HAMD or MADRS, and 8 for the BDRS, we recommend a total score of 8 as a lower boundary for subsyndromal depression on the HAMD or MADRS, and 9 for the BDRS. Subsyndromal mania....

    [...]

Journal Article•DOI•
The PHQ-9: validity of a brief depression severity measure.

[...]

Kurt Kroenke1, Robert L. Spitzer2, Janet B. W. Williams2•
Indiana University – Purdue University Indianapolis1, Columbia University2
01 Sep 2001-Journal of General Internal Medicine
TL;DR: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity, which makes it a useful clinical and research tool.
Abstract: OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.

26,004 citations

Journal Article•DOI•
Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication

[...]

Ronald C. Kessler1, Patricia A. Berglund1, Olga Demler1, Robert Jin1, Kathleen R. Merikangas, Ellen E. Walters1 •
Harvard University1
01 Jun 2005-Archives of General Psychiatry
TL;DR: Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.
Abstract: Context Little is known about lifetime prevalence or age of onset of DSM-IV disorders. Objective To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Main Outcome Measures Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Results Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. Conclusions About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

17,213 citations

"The International Society for Bipol..." refers background in this paper

  • ...In particular, the most frequently employed scales inadequately assess symptoms of anxiety, which are prominent in all phases of bipolar disorders (65)....

    [...]

Journal Article•DOI•
A new depression scale designed to be sensitive to change.

[...]

Stuart Montgomery, Marie Åsberg1•
Royal College of Psychiatrists1
01 Apr 1979-British Journal of Psychiatry
TL;DR: The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described, and its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change.
Abstract: The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample. Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change. The inner-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.

11,923 citations

"The International Society for Bipol..." refers background or methods in this paper

  • ...This is in contrast to response, which is defined in such a way that subjects who started a study with a YMRS score of 50 (1–60 scale) or a MADRS score of 40 would be still be clearly symptomatic, despite having achieved a 50% reduction in baseline severity....

    [...]

  • ...A HAMD-17 score £ 7 corresponds to a MADRS score £ 9 (30) or a 30- item IDS-Clinician-Rated (IDS-C30) score £ 12, an IDS Self-Report (IDS-SIR) score £ 14 (30), or a QIDS-C16 or QIDS-SIR score £ 5 (25, 26)....

    [...]

  • ...Berk et al. (34) found that scores < 5 in the MADRS scale correlate better with a CGI score = 1....

    [...]

  • ...For unipolar depression, response has typically been defined as a ‡ 50% reduction in pretreatment symptom severity using symptom rating scales such as the Hamilton Rating Scale for Depression (HAMD) (14), the Montgomery-Åsberg Depression Rating Scale (MADRS) (15), the Inventory for Depression Symptomatology (IDS) (16), and the Bipolar Depression Rating Scale (BDRS) (17)....

    [...]

  • ...Considering a score of 7 as an upper boundary for defining remission status with the HAMD or MADRS, and 8 for the BDRS, we recommend a total score of 8 as a lower boundary for subsyndromal depression on the HAMD or MADRS, and 9 for the BDRS. Subsyndromal mania....

    [...]

Related Papers (5)
A rating scale for mania: reliability, validity and sensitivity.

[...]

01 Nov 1978-British Journal of Psychiatry
R. C. Young, John T. Biggs, Vincent E. Ziegler, D. A. Meyer 
A rating scale for depression

[...]

01 Feb 1960-Journal of Neurology, Neurosurgery, and Psychiatry
Max Hamilton
A new depression scale designed to be sensitive to change.

[...]

01 Apr 1979-British Journal of Psychiatry
Stuart Montgomery, Marie Åsberg
Diagnostic and Statistical Manual of Mental Disorders

[...]

11 Jun 2013
Janet B. W. Williams
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.

[...]

01 Feb 2013-Bipolar Disorders
Lakshmi N. Yatham, Sidney H. Kennedy, Sagar V. Parikh, Ayal Schaffer, Serge Beaulieu, Martin Alda, Claire O'Donovan, Glenda MacQueen, Roger S. McIntyre, Verinder Sharma, Arun V. Ravindran, L. Trevor Young, Roumen Milev, David J. Bond, Benicio N. Frey, Benjamin I. Goldstein, Beny Lafer, Boris Birmaher, Kyooseob Ha, Willem A. Nolen, Michael Berk, Michael Berk