University of Michigan Medical School, Department of Family Medicine, 1018 Fuller Street, Ann Arbor, MI 48104-1213, USA.
Gen Hosp Psychiatry. 2011 May-Jun;33(3):279-86. doi: 10.1016/j.genhosppsych.2011.03.002. Epub 2011 May 6.
Depression remission continues to be defined in terms of resolution of the Diagnostic and Statistical Manual of Mental Disorders criteria symptoms. However, it may be useful to assess additional symptoms as part of a more complete evaluation of remission. We sought to develop an adjunct self-report measure that can be used with commonly used depression measures when assessing remission.
Secondary data analysis and expert input were used to develop candidate items that were evaluated cross-sectionally in 1003 primary care clinician-identified depressed patients from two practice-based research networks. Multivariable regression analysis, with self-assessed recovery as the dependent variable, identified five symptoms that contributed significantly beyond the Patient Health Questionnaire (PHQ)-8. Further analysis was performed in selected subsamples.
Emotional control, contentedness, future seeming dark, ability to bounce back and happiness yielded an 11% increase in R(2) beyond 60% yielded by the PHQ-8. The summed Remission Evaluation and Mood Inventory Tool (REMIT) 5 items have a mean=9.6 (S.D.=4.5), range 0-20 and reliability of 0.86. Subsample analysis showed incremental R(2) ranging from 9% in men to 15% in African-Americans.
Depression remission is a multidimensional concept that includes important nondepressive symptom dimensions. These important dimensions can be measured using a self-report instrument feasible for routine primary care. Pending longitudinal validation, REMIT5 is a promising tool for depression management.
抑郁症的缓解仍以《精神障碍诊断与统计手册》（DSM）标准症状的消除来定义。然而，评估其他症状可能有助于更全面地评估缓解情况。我们试图开发一种附加的自我报告量表，当评估缓解时，可以与常用的抑郁症量表一起使用。
使用二次数据分析和专家意见开发候选项目，在来自两个基于实践的研究网络的 1003 名初级保健临床医生确定的抑郁患者中进行横断面评估。多变量回归分析，以自我评估的恢复为因变量，确定了五个症状，这些症状除了 PHQ-8 之外还有显著贡献。在选定的子样本中进行了进一步分析。
情绪控制、满足感、未来似乎黯淡、恢复能力和幸福感使 PHQ-8 产生的 60%以上的 R²增加了 11%。缓解评估和情绪量表工具（REMIT）的 5 个总和项目的平均值为 9.6（S.D.=4.5），范围为 0-20，可靠性为 0.86。子样本分析显示，男性的 R²增加了 9%，非裔美国人增加了 15%。
抑郁症缓解是一个多维概念，包括重要的非抑郁症状维度。这些重要的维度可以使用自我报告工具来衡量，该工具适用于常规初级保健。在等待纵向验证的情况下，REMIT5 是一种有前途的抑郁症管理工具。
