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AJP CME: November 2016 - A Brief Clinical Tool to Estimate Individual Patients’ Risk of Depressive Relapse Following Remission: Proof of Concept

Activity Type:

  • Journal CME

Release Date: 11/1/2016

Expiration Date: 10/31/2018

  • AMA PRA Category 1 Physician: 1
  • Participation: 1

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Objective: The authors sought to determine whether symptoms experienced by formerly depressed patients after at least 8 weeks of remission can be used to identify their risk for relapse during the next 6 months.

Method: The study included 188 patients with major depressive disorder from the National Institute of Mental Health Collaborative Depression Study who had at least one Symptom Checklist–90 (SCL-90) assessment after at least 8 weeks of full remission from a depressive episode (defined as a value of 1 on the weekly psychiatric rating scale for all depressive conditions, recorded on Longitudinal Follow-Up Evaluation interviews). Mixed logistic regression was used to identify a set of SCL-90 items that were most predictive of relapse compared with nonrelapse within the next 6 months.

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Educational Objective

The participant will recognize that a brief self-report symptom scale can identify risk of depressive relapse for individual patients who have been fully remitted.

Target Audience

This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.

Estimated Time to Complete

Duration: 1 hour
Begin Date: November 1, 2016
End Date: October 31, 2018

How to Earn Credit

In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™).  A score of 60% or higher is required to receive credit.


The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Title: A Brief Clinical Tool to Estimate Individual Patients’ Risk of Depressive Relapse Following Remission: Proof of Concept

Authors: Lewis L. Judd, M.D., Pamela J. Schettler, Ph.D., A. John Rush, M.D.

Affiliations: From the Department of Psychiatry, University of California, San Diego, La Jolla (L.L.J., P.J.S.); and the Department of Psychiatry, Duke–National University of Singapore, Singapore (A.J.R.).

Disclosures: Dr. Rush has received consulting fees from the American Psychiatric Association, Brain Resource, Duke–National University of Singapore, Eli Lilly, Emmes Corporation, LivaNova, Lundbeck, MedAvante, Montana State University, NIDA, Santium, Stanford University, Takeda, the University of Colorado, the University of Texas Southwestern Medical Center; speaking fees from the American Society for Clinical Psychopharmacology, Hershey Penn State Medical Center, New York State Psychiatric Institute, Stanford Medical School, SingHealth–National University of Singapore, and the University of California, San Diego; royalties from Guilford Publications and the University of Texas Southwestern Medical Center; a travel grant from CINP; and research support from Duke–National University of Singapore; through the University of Texas Southwestern Medical Center, he has a potential financial interest in the Inventory of Depressive Symptomatology and several variations of it. Drs. Judd and Schettler report no financial relationships with commercial interests.

Discussion of unapproved or investigational use of products*: No.

*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.

Program Planners

Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP) ; Michael A. Pogachar (Online Content Manager, Journals).

Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.

Hardware/Software Requirements

Hardware/Software Specifications: 
This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

  • Flash Player: Adobe Flash Player 10.1+ 
  • Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+ 
  • Operating System: Windows XP+ or Mac OS X 10.4+ 
  • Internet Connection: 1 Mbps or higher
  • Screen Resolution: 1024 x 768 pixels.

Minimum Requirements:

  • Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
  • Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit

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