Toward a more comprehensive assessment of depression remission: The Remission Evaluation and Mood Inventory Tool (REMIT)

Donald E. Nease, James E. Aikens, Michael S. Klinkman, Kurt Kroenke, Ananda Sen

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: 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. Methods: 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. Results: Emotional control, contentedness, future seeming dark, ability to bounce back and happiness yielded an 11% increase in R2 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 R2 ranging from 9% in men to 15% in African-Americans. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)279-286
Number of pages8
JournalGeneral Hospital Psychiatry
Volume33
Issue number3
DOIs
StatePublished - May 1 2011

Keywords

  • Depression
  • Measurement-based care
  • Primary care
  • Remission

ASJC Scopus subject areas

  • Psychiatry and Mental health

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