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We applaud the effort of Drs Philipp and Fickinger that clearly underscores the point made in our report: varying definitions of response or remission will lead to quite different lengths of episode and illness-free periods. The careful follow-up study of 66 psychiatric inpatients described above clearly demonstrates that an episode can be anywhere from 1 to more than 6 months in length depending on the particular criteria set for defining remission. We concur that a broad consensus on operational definitions of change points would lead to a more interpretable literature on depressive illness. We look forward to seeing the authors' demonstration that the cutoff 3/4 leads to the most valid definition of remission, since the validity of various cutoffs must be established before consensus definitions can be promulgated appropriately.
Supported in part by a grant from the John D. and Catherine T. MacArthur Foundation Research Network on the Psychobiology of
Frank E, Kupfer DJ. The Definition of Remission and Its Impact on the Length of a Depressive Episode-Reply. Arch Gen Psychiatry. 1993;50(5):408. doi:10.1001/archpsyc.1993.01820170094014