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May 1993

The Definition of Remission and Its Impact on the Length of a Depressive Episode-Reply

Author Affiliations

Department of Psychiatry University of Pittsburgh School of Medicine Western Psychiatric Institute and Clinic Pittsburgh, PA 15213-2593

Arch Gen Psychiatry. 1993;50(5):408. doi:10.1001/archpsyc.1993.01820170094014

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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

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