Unipolar major depression is currently the fourth leading cause of disease burden in the world. It is projected to move up to second place, outranked only by ischemic heart disease, by the year 2020. Prospective follow-up studies of large cohorts of depressed individuals have emphasized that the presence of sub-threshold and residual depressive symptoms is associated with high rates of recurrence of depressive episodes, suicide attempts, job absenteeism, disability, and chronicity.

Given these findings, the classical endpoint of "response" to treatment – usually defined as a reduction in symptomatology of at least 50% – is now considered an inadequate outcome in clinical practice. Instead, the primary goals of treatment are now defined as follows:

• to reduce and eliminate all signs and symptoms of depression
• to restore occupational and psychosocial functioning to that of the asymptomatic state
• to reduce relapses and recurrences, i.e., to promote recovery.
  

The "Full Remission" program has been developed to communicate information about these redefined goals of treatment, and to provide physicians with a practical basis from which to apply these principles to management of patients with depression. This program utilizes the "Guidelines for the Diagnosis and Pharmacological Treatment of Depression (1st Edition Rev. 1999, the Canadian Network for Mood and Anxiety Treatments), as the foundation from which to advance the diagnosis and pharmacotherapy of depression.

Learning Objectives
Upon completion of this program, physicians will be able to:
1. Define the goals of antidepressant treatment, with emphasis on the goal of remission
2. Recognize the prevalence and implications of partial remission
3. Apply the knowledge gained through this program to clinical practice to improve patient outcomes by pursuing full remission.

Proceed to Section II - "Learning Needs Survey"