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Chart Review and Exploration of Sustaining Remission in Major Depressive Disorder

neuroscienceCME Chart Review

Premiere Date: Thursday, December 1, 2011

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Psychologists (APA)
  4. Social Workers (NASW)
  5. Certified Case Managers (CCMC)
  6. Pharmacists (ACPE)


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Saturday, December 1, 2012
Note: Credit Is No Longer Available

Faculty


Rakesh Jain, MD, MPHRakesh Jain, MD, MPH (Moderator)
Clinical Professor, Department of Psychiatry
Texas Tech Health Sciences Center School of Medicine – Permian Basin
Midland, TX

Michael E. Thase, MDMichael E. Thase, MD 
Professor of Psychiatry
Department of Psychiatry
Perelman School of Medicine at the University of Pennsylvania
Corporal Michael J. Crescenz Veterans Affairs Medical Center
Philadelphia, PA

Statement of Need

For patients with major depressive disorder (MDD), achieving remission is the penultimate therapeutic goal. Still, many patients treated with the standard initial treatment do not achieve a full and durable response. Rather, they are at high risk for residual and recurrent symptoms, treatment-resistance, and relapse.(1) This neuroscienceCME Chart Review activity addresses clinician-based gaps that may contribute to suboptimal rates of long-term, sustained remission among patients with MDD. Specifically, an index patient case will be used as the content foundation upon which expert faculty will engage in a provocative, consult-type exchange.

As a participants, you will benefit from a robust discussion of the clinical decisions and course of the index patient that folds in recommendations from treatment guidelines,(2) data from well-controlled studies,(3) and pearls from national and international experts. Consider it a medical soap opera and join us!


  1. Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-1917. PMID: 17074942.
  2. Gelenberg AJ (chair), Freeman MP, Markowitz JC, et al.; Work Group on Major Depressive Disorder of the American Psychiatric Association [APA]. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. 3rd ed. APA Website. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Published November 2010. Accessed September 12, 2011.
  3. Rush AJ. STAR-D: lessons learned and future implications. Depress Anxiety. 2011;28(7):521-524. PMID: 21721070.

Activity Goal

Through achievement of the specified, gaps-based learning objectives, clinician learners will manage major depression using evidence-based strategies that are most likely to result in durable remission.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Identify clinical factors associated with sustained remission in major depressive disorder (MDD).
  • Assess treatment response and clinical status in major depressive disorder through routine, systematic use of measurement-based care concepts and validated rating scales.
  • Modify treatment plans for refractory or relapsed patients with major depressive disorder according to the best fit of patient needs with clinical profiles for evidence-based pharmacological and nonpharmacological treatment options.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Identify clinical factors associated with sustained remission in major depressive disorder (MDD).
  • Describe patient-completed, validated questionnaires and rating scales used to measure clinical response and remission in patients with major depressive disorder.
  • Describe the clinical profiles of evidence-based pharmacological and nonpharmacological treatment options commonly used in treatment-resistant major depressive disorder.

Financial Support

Supported in part by an educational grant from AstraZeneca, LP
Supported in part by CME Outfitters, LLC.

Target Audience

Physicians, physician assistants, nurses, nurse practitioners, pharmacists, and other health care professionals with an interest in major depressive disorder.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hours.

CEP Credit (Psychologists):
CME Outfitters is approved by the American Psychological Association to sponsor continuing education for psychologists. CME Outfitters maintains responsibility for this program and its content. (1.0 CE credits)

NASW Credit (Social Workers):
This program was approved by the National Association of Social Workers (provider #886407722) for 1 continuing education contact hour.

CCMC Credit (Certified Case Managers):
This program has been approved for 1 hour by the Commission for Case Manager Certification (CCMC).

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs)
Universal Activity Number: 0376-0000-11-025-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/test (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Jain has disclosed that he receives grants from AstraZeneca; Forest Laboratories, Inc.; Eli Lilly and Company; Pfizer Inc.; and Shire Pharmaceuticals. He serves as a consultant to Addrenex Pharmaceuticals, Inc.; Forest Laboratories, Inc.; Eli Lilly and Company; Merck & Co., Inc.; Pamlab, L.L.C.; Pfizer Inc.; Shionogi Inc.; Shire Pharmaceuticals; and Sunovion Pharmaceuticals Inc. He is on the speakers bureaus of Addrenex Pharmaceuticals, Inc.; Forest Laboratories, Inc.; Eli Lilly and Company; Merck & Co., Inc.; Pamlab, L.L.C.; Pfizer Inc.; Shionogi Inc.; Shire Pharmaceuticals; and Sunovion Pharmaceuticals Inc. He is on the advisory boards of Addrenex Pharmaceuticals, Inc.; Eli Lilly and Company; Merck & Co., Inc.; Pamlab, L.L.C.; Pfizer Inc.; Shionogi Inc.; Shire Pharmaceuticals; and Sunovion Pharmaceuticals Inc.

Dr. Thase has disclosed that he has received research grants from Agency for Healthcare Research and Quality; Eli Lilly and Company; Forest Pharmaceuticals, Inc.; National Institute of Mental Health; and Otsuka America Pharmaceutical, Inc. He has made promotional presentations on behalf of AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company; Dey Pharma, L.P.; Merck & Co., Inc.; and Pfizer Inc. He serves as a consultant for Alkermes, Inc.; AstraZeneca; Bristol-Myers Squibb Company; Eli Lilly and Company.; Dey Pharma, L.P.; Forest Pharmaceuticals, Inc.; Gerson Lehrman Group, Inc.; Guidepoint Global; H. Lundbeck A/S; MedAvante, Inc.; Merck & Co., Inc.; Neuronetics; Otsuka America Pharmaceutical, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Pamlab, LLC; Pfizer Inc.; PGxHealth, Inc; Shire US Inc..; Supernus Pharmaceuticals, Inc.; Takeda Pharmaceuticals North America, Inc.; and Transcept Pharmaceuticals , Inc. He has equity holdings in MedAvante, Inc. and received royalties from American Psychiatric Foundation; Guilford Publications; Herald Publishing House; and W.W. Norton & Company, Inc.

Tony Graham, MD (content/peer review) has no disclosures to report.

Ruth Cody, BSN, RN-BC (content/peer reviewer) has no disclosures to report.

Nancy Jennings, MSN, MBA, MHA, RNC (content/peer reviewer) has no disclosures to report.

Monique Johnson, MD, CCMEP (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has not disclosures to report.

Unlabeled Use Disclosure

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and AstraZeneca Pharmaceuticals do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

CR-010-120111-13

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