In an attempt to overcome these flaws, Frank et al2 proposed a se

In an attempt to overcome these flaws, Frank et al2 proposed a set of definitions which they referred to as longitudinal studies of mood disorders, but, may entail more general applicability in psychiatry. Remission (which is differentiated into partial and full remission) is a relatively brief period during which an improvement, of sufficient magnitude is OSI906 observed and the individual no longer meets syndromal criteria for the disorder. Recovery implies a more

sustained remission, and raises the possibility that treatment can be discontinued or prolonged with the aim of prevention. Relapse is a return Inhibitors,research,lifescience,medical of symptoms satisfying the full syndromal criteria during the period of remission, whereas recurrence can occur only during a recovery. The development of these criteria provides helpful ground for decreasing inconsistencies among research reports, yet, it does not, touch some key issues in the conceptualization of these terms. First, according

to these definitions,2 recovery occurs Inhibitors,research,lifescience,medical when the number and severity of symptoms fall below the threshold used for defining onset, and this Inhibitors,research,lifescience,medical subthreshold level of symptomatology remains for a specified period of time. However, this state cannot be equated with being asymptomatic, and provides room for a wide range of subclinical conditions. Second, the definition of remission parallels the traditional medical concept, of convalescence, a transitional period of reintegration after illness.

The trajectory of such a process is thus an important additional dimension Inhibitors,research,lifescience,medical which requires a longitudinal consideration of the development of disorders, encompassing the prodromal phase, the fully developed disorder, and residual states. Not only the duration of the acute phase of illness -as is widely acknowledged- may affect, the rate of recovery, but also the characteristics of prodromes, the Inhibitors,research,lifescience,medical amount, of residual symptomatology not alleviated by specific treatments, and the level of premorbid functioning may influence the course of recovery.3,4 Finally, either the distinction between recovery and full remission is made on temporal grounds only. They are not, differentiated by whether active treatment, is associated, even though recovery implies the possibility that therapy can be discontinued. A recovered depressed patient who is currently drug-free is thus equated to another patient, who is receiving long-term, high-dose antidepressant, treatment. The aim of this review is to analyze some issues which would help to define the psychosocial determinants of recovery in depression. The inadequacies of standard clinical assessment The staging method, whereby a disorder is characterized according to seriousness, extent, and features, has achieved wide currency in medicine, but, is currently neglected in psychiatry.

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