Table 1. Measurement-Based Care and Tactics for Acute Phase Treatment of Major Depressive Disorder.
Critical Decision Point (CDP) | Clinical Status | Plan | |
---|---|---|---|
Week 0 (CDP #1) | HAM-D17 ≥ 14 | Symptomatic |
|
Week 4 (CDP #2) | QIDS-C16 ≤5 | Remission |
|
QIDS-C16 = 6-8 | Partial Response |
|
|
SEs intolerable |
|
||
QIDS-C16 ≥9 | Nonresponse |
|
|
SEs intolerable |
|
||
Week 6 (CDP #3) | QIDS-C16 ≤5 | Remission |
|
QIDS-C16 = 6-8 | Partial Response |
|
|
SEs intolerable |
|
||
QIDS-C16 ≥9 | Nonresponse |
|
|
SEs intolerable |
|
||
Week 9 CDP #4) | QIDS-C16 ≤5 | Remission |
|
QIDS-C16 = 6-8 | Partial Response |
|
|
QIDS-C16 ≥9 | Nonresponse or SEs intolerable |
|
|
Week 12 (CDP #5) | QIDS-C16 ≤5 | Remission |
|
QIDS-C16 = 6-8 | Partial Response |
|
|
QIDS-C16 ≥9 | Nonresponse or SEs intolerable |
|
If after 12 weeks the patient has not remitted, but the clinician feels that 2 more weeks of treatment would be beneficial, treatment may be extended.
QIDS-C16, 16-item Quick Inventory of Depressive Symptomatology – Clinician-rated; SEs, side effects; HAM-D17, 17-item Hamilton Depression Rating Scale