SynopsisThe psychometric properties of the 28- and 30-item versions of the Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C) and Self-Report (IDS-SR) are reported in a total of 434 (28-item) and 337 (30-item) adult out-patients with current major depressive disorder and 118 adult euthymic subjects (15 remitted depressed and 103 normal controls). Cronbach's α ranged from 0·92 to 0·94 for the total sample and from 0·76 to 0·82 for those with current depression.Item total correlations, as well as several tests of concurrent and discriminant validity are reported. Factor analysis revealed three dimensions (cognitive/mood, anxiety/arousal and vegetative) for each scale. Analysis of sensitivity to change in symptom severity in an open-label trial of fluoxetine (N = 58) showed that the IDS-C and IDS-SR were highly related to the 17-item Hamilton Rating Scale for Depression. Given the more complete item coverage, satisfactory psychometric properties, and high correlations with the above standard ratings, the 30-item IDS-C and IDS-SR can be used to evaluate depressive symptom severity. The availability of similar item content for clinician-rated and self-reported versions allows more direct evaluations of these two perspectives.

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Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse-recur (29% within 1 year and 54% within 2 years). These rates appear comparable to those associated with other depression-specific psychotherapies but lower than those associated with pharmacotherapy. Among acute-phase treatment responders, continuation-phase CT reduced relapse-recurrence compared with assessment only at the end of continuation treatment (21% reduction) and at follow-up (29% reduction). Continuation-phase CT also reduced relapserecurrence compared with other active continuation treatments at the end of continuation treatment (12% reduction) and at follow-up (14% reduction). The authors discuss implications for research and patient care and suggest directions, with methodological refinements, for future studies. Keywordsdepression; relapse and recurrence; cognitive-behavioral therapy; continuation and maintenance treatment; meta-analysis High prevalence and frequent relapse and recurrence amplify the public health significance of major depressive disorder (MDD). Epidemiological estimates place the lifetime prevalence of MDD at more than 16% (Kessler, Berglund, Demler, Jin, & Walters, 2005), and 14% of primary-care patients meet criteria for a major depressive episode (MDE; Ansseau et al., 2004). The large majority of individuals with MDD experience more than one MDE (Judd, 1997;Mueller et al., 1999), and the probability of another MDE increases with each relapserecurrence (Solomon et al., 2000; American Psychiatric Association, 2000a). For example, perhaps 85% of people who recover from an MDE will experience a second MDE within 15 years of naturalistic follow-up, and each additional episode increases the risk of relapserecurrence by 18% (Mueller et al., 1999). Consequently, life interference (e.g., lost work productivity, mortality, lower quality of life) due to MDD rivals that of other chronic diseases such as cancer, diabetes, and heart disease (Murray & Lopez, 1996;Simon, 2003), and most people who commit suicide are depressed (Fawcett, 1993).CorrespondenceThe risk of suicide and life interference can be reduced by shortening the duration of MDEs with effective acute-phase treatments, including pharmacotherapy, interpersonal psychotherapy, and cognitive-behavioral therapy (CT; Hollon, Jarrett, et al., 2005). We define acute-phase treatments as those applied during an MDE with the goal of reducing depressive symptoms and producing initial remission. Responders to some acute-phase treatments (e.g., CT) may receive some protection from relapse-recurrence (Hollon, Thase, & Markowitz, 2002), but prevalent relapse-recurrence after successful antidepressant treatments has ...

Findings suggest that 8 months of C-CT significantly reduces relapse and recurrence in the highest-risk patients with recurrent MDD. Risk factors influenced the necessity for C-CT.

In practical terms, the sine qua non of the modes, methods, devices, strategies, and theories of clinical assessment is their contribution to treatment outcome. The importance of this contribution has often been noted, but under many different labels and rationales. The resultant conceptual confusion has considerably restricted the visibility and frequency of research in this critical area. In this article we propose a name for the impact of assessment on treatment outcome: the "treatment utility of assessment. "' Some of the questions that can be asked about the treatment utility of assessment are described, and methods appropriate for asking them are examined. Finally, the implications of this kind of utility for other approaches to evaluating assessment quality are analyzed.