Clinical correlates of complete versus partial remission in major depressive disorder: an exploratory analysis of three cohorts

Remission in major depressive disorder (MDD) is conventionally defined as a 17-item Hamilton Depression Rating Scale (HAMD-17) score ≤7, but patients within this range may retain residual symptoms. We explored whether complete remission (HAMD-17 <4) and partial remission (HAMD-17 4-7) differ in baseline clinical features, symptom trajectories and endpoint functioning. Three cohorts were analysed separately: GSRD (N=2583, cross-sectional, tertiary centres), PANDORA (N=215, week 12) and STAR*D level 1 (N=1565). We estimated effect sizes with 95% confidence intervals, false discovery rate (FDR) correction, adjusted and imputed models, alternative cut-offs, individual symptom trajectories and cross-validated discrimination. Baseline differences between complete and partial remitters were small (median absolute standardized difference 0.08-0.15). No baseline variable survived FDR correction; only a concurrent severe-episode rating in GSRD did (odds ratio 2.10, 95% CI 1.43-3.07). In STAR*D, partial remitters had slightly higher baseline HAMD-17 (g=0.15, 95% CI 0.00-0.31), and most item-level associations were explained by overall severity. Baseline features did not discriminate the groups in individual patients (cross-validated AUC 0.42-0.55). Symptom scores of the two groups separated within 4-6 weeks and did not converge during follow-up. In STAR*D, the estimated rate of improvement did not differ detectably, and the model-estimated asymptote was higher in partial remitters. At STAR*D exit, partial remitters had worse work and social adjustment (g=0.45) and quality of life (g=-0.63) despite similar baseline values. Complete and partial remission identify different endpoint states, but baseline clinical features predict this distinction poorly. These exploratory findings require prospective confirmation.

Authors

Institutions

Publication Details

Journal
European Neuropsychopharmacology
Published
2026-10-30
DOI
https://doi.org/10.1016/j.euroneuro.2026.113898
Primary Topic
Treatment of Major Depression
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Clinical correlates of complete versus partial remission in major depressive disorder: an exploratory analysis of three cohorts

Stuart Montgomery, Joseph Zohar, Gabriele Nibbio, Panagiotis P. Ferentinos et al.
European Neuropsychopharmacology
Treatment of Major Depression
article

Clinical correlates of complete versus partial remission in major depressive disorder: an exploratory analysis of three cohorts

Stuart Montgomery, Joseph Zohar, Gabriele Nibbio, Panagiotis P. Ferentinos, Julien Mendlewicz, Raffaella Zanardi, Giulia Perusi, Massimo Gennarelli, Lisa Buson, Stefano Bignotti, Dan Rujescu, Giovanni Battista Tura, Marco Bortolomasi, Daniel Souery, Alessandro Serretti, Valentina Menesello, Rosana Carvalho Silva, Alessandra Minelli, Siegfried Kasper, Filippo Drago, Stefano Barlati, Raffaele Ferri, Antonio Vita
article en

Abstract

Remission in major depressive disorder (MDD) is conventionally defined as a 17-item Hamilton Depression Rating Scale (HAMD-17) score ≤7, but patients within this range may retain residual symptoms. We explored whether complete remission (HAMD-17 <4) and partial remission (HAMD-17 4-7) differ in baseline clinical features, symptom trajectories and endpoint functioning. Three cohorts were analysed separately: GSRD (N=2583, cross-sectional, tertiary centres), PANDORA (N=215, week 12) and STAR*D level 1 (N=1565). We estimated effect sizes with 95% confidence intervals, false discovery rate (FDR) correction, adjusted and imputed models, alternative cut-offs, individual symptom trajectories and cross-validated discrimination. Baseline differences between complete and partial remitters were small (median absolute standardized difference 0.08-0.15). No baseline variable survived FDR correction; only a concurrent severe-episode rating in GSRD did (odds ratio 2.10, 95% CI 1.43-3.07). In STAR*D, partial remitters had slightly higher baseline HAMD-17 (g=0.15, 95% CI 0.00-0.31), and most item-level associations were explained by overall severity. Baseline features did not discriminate the groups in individual patients (cross-validated AUC 0.42-0.55). Symptom scores of the two groups separated within 4-6 weeks and did not converge during follow-up. In STAR*D, the estimated rate of improvement did not differ detectably, and the model-estimated asymptote was higher in partial remitters. At STAR*D exit, partial remitters had worse work and social adjustment (g=0.45) and quality of life (g=-0.63) despite similar baseline values. Complete and partial remission identify different endpoint states, but baseline clinical features predict this distinction poorly. These exploratory findings require prospective confirmation.

European NeuropsychopharmacologyVol. 114
Université Libre de Bruxelles (BE), Vita-Salute San Raffaele University (IT), Tel Aviv University (IL), National and Kapodistrian University of Athens (GR), Università degli Studi di Enna Kore (IT), Sheba Medical Center (IL), University of Catania (IT), Oasi Maria SS (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Centro San Giovanni di Dio Fatebenefratelli (IT), I.R.C.C.S. Oasi Maria SS (IT), IRCCS Ospedale San Raffaele (IT), Imperial College London (GB), Medical University of Vienna (AT), University of Brescia (IT)
Good health and well-being
Openalex Percentile: Top 13%
Treatment of Major Depression
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.

Laika access coming soon