ANN ARBOR, Mich. Primary care doctors have long been on the front lines of depression treatment. Depression is listed as a diagnosis for 1 in 10 office visits and primary care doctors prescribe more than half of all antidepressants.

Now doctors at the University of Michigan Health System have developed a new tool that may help family physicians better evaluate the extent to which a patient's depression has improved.

The issue, the researchers explain, is that the official definition of when a patient's symptoms are in remission doesn't always match up with what doctors see in a real-world practice, especially for patients with mild to moderate symptoms. The study will be published in the upcoming issue of General Hospital Psychiatry.

"Rather than simply going down a list and checking off a patient's lack of individual symptoms, we believe there are also positive signs that are important a patient's feeling that they are returning to 'normal,' their sense of well-being, their satisfaction with life and their ability to cope with life's ups and downs," says lead author Donald E. Nease Jr., M.D., who was an associate professor of family medicine at the U-M Medical School and member of the U-M Depression Center at the time of the research.

Nease and his colleagues developed a series of five questions such as, "Over the last two weeks, did you feel in control of your emotions?" that they hope will help doctors better understand a patient's inner landscape.

The remission criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) doesn't necessarily correspond to a patient's own sense of recovery, Nease explains.

For example, a patient could meet all the criteria for full remission, but still not feel that he had recovered. The U-M questionnaire, which is called Remission Evaluation and Mood Inventory Tool, or REMIT, is intended to add the patient's subjective sense of re
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