Clinical significance and remission in treating major depressive disorder: parallels between related outcome constructs

Abstract

Over the last several years, research has increasingly focused on how to meaningfully characterize treatment outcome, with different terminologies emerging. In the psychotherapy and behavioral assessment research, clinical significance has emerged as the dominant term to describe the assessment of meaningful change due to treatment, whereas for certain psychiatric disorders remission is the term most commonly used to represent the posttreatment assessment of clinically meaningful change. In the treatment of major depressive disorder, these two constructs exhibit parallels in terms of methodology and conceptual themes, though the two lines of outcomes research using these terms have proceeded along largely isolated paths with little acknowledgment of their shared concerns. With a particular focus on the depression literature, this review summarizes the features, concepts, and debates common to both outcome constructs, and suggests future research on these methods that are used to define meaningful treatment outcome.