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Managing the Full Range of Symptoms to Achieve Lasting Remission

Using Measurement Strategies to Identify and Monitor Residual Symptoms

Roger S. McIntyre, MD

Published: October 29, 2013

Article Abstract

Major depressive disorder (MDD) is a persistent, pervasive, and chronic disorder that significantly affects patients’ functioning and quality of life. Most patients treated for MDD continue to have residual symptoms after acute treatment with pharmacotherapy. One of the most commonly encountered residual symptoms is cognitive dysfunction, which substantially affects patient outcomes. While antidepressant monotherapy is an effective first-line treatment for some patients with MDD, patients with residual symptoms (eg, cognitive dysfunction) will require an additional treatment intervention such as augmentation or switch to an alternative treatment strategy. Measurement-based care has been demonstrated to improve patient outcomes in MDD. The clinical importance of cognitive dysfunction in MDD invites the need to probe, screen, and measure the extent of cognitive impairment.

(J Clin Psychiatry 2013;74[suppl 2]:14-18)

From the Department of Psychiatry, University of Toronto, and the Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.

This article is derived from the planning teleconference series "Depression: Managing the Full Range of Symptoms to Achieve Lasting Remission," which was held in May and June 2013 and supported by an educational grant from Takeda Pharmaceuticals International, Inc., US Region and Lundbeck.

Dr McIntyre has served on the advisory boards for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, France Foundation, GlaxoSmithKline, Janssen-Ortho, Lundbeck, Merck, Organon, Pfizer, and Shire; has served on the speakers bureaus for AstraZeneca, Eli Lilly, Janssen-Ortho, Lundbeck, Merck, and Pfizer; has received grant/research support from AstraZeneca, Eli Lilly, Janssen-Ortho, Lundbeck, the National Alliance for Research on Schizophrenia and Depression, the National Institutes of Mental Health, Pfizer, Shire, and the Stanley Medical Research Institute; and has participated in CME activities for AstraZeneca, Bristol-Myers Squibb, CME Outfitters, Eli Lilly, France Foundation, I3CME, Merck, Optum Health, and Pfizer.

Corresponding author: Roger S. McIntyre, MD, 399 Bathurst St, MP 9-325, Toronto, Ontario, M5T 2S8, Canada (

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