J. McGlinchey

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Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have suggested that(More)
This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for(More)
The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project examined whether symptoms that are not part of the DSM-IV definition of major depressive disorder (MDD) are better at discriminating depressed from nondepressed patients than the current criteria. Symptoms assessed included diminished drive, helplessness,(More)
OBJECTIVE Although experts in the treatment of depression have suggested that achieving remission is the primary goal of treatment, questions remain about how remission should be defined. In antidepressant efficacy trials, remission is defined according to scores on symptom severity scales. Normalization of functioning is often mentioned as an important(More)
Psychopathologists have long debated the latent structure of mental disorders, and a number of researchers have suggested that depression may be best characterized as a continuous, rather than categorical, phenomenon. Nonetheless, attention has been drawn to limitations permeating existing research and the need for studies using more appropriate statistical(More)
The diagnostic criteria for depression were developed on the basis of clinical experience rather than empirical study. Although they have been available and widely used for many years, few studies have examined the psychometric properties of the DSM criteria for major depression. In the present report from the Rhode Island Methods to Improve Diagnostic(More)
OBJECTIVE A survey of psychiatrists in the United Kingdom found that only a minority routinely used standardized measures to assess outcome when treating depression and anxiety disorders. The goals of the present study were to determine how frequently psychiatrists in the United States use scales to measure outcome when treating depressed patients and, for(More)
There are two practical problems with the DSM-IV symptom criteria for major depressive disorder (MDD)--they are somewhat lengthy and therefore difficult to remember, and there are difficulties in applying some of the criteria in patients with comorbid medical illnesses because of symptom nonspecificity. Therefore, in the present report from the Rhode Island(More)
BACKGROUND The largest clinical epidemiological surveys of psychiatric disorders have been based on unstructured clinical evaluations. However, several recent studies have questioned the accuracy and thoroughness of clinical diagnostic interviews; consequently, clinical epidemiological studies, like community-based studies, should be based on standardized(More)
Considerable research has evaluated biological and psychological tests for various psychiatric disorders; however, few objective tests are included in DSM-IV as diagnostic criteria. It was recently suggested that existing tests are insufficiently accurate to be included as diagnostic criteria. While it is true that there are limitations in the sensitivity(More)