Sensitizing clinicians and patients to the social and functional aspects of remission

Axis I disorders are defined by specific symptom constellations that are frequently accompanied by notable impairments in social functioning. Social role impairments diminish personal fulfillment, satisfaction, and quality of life. It is now clear that these findings suggest a broader definition of remission that involves not only the absence of symptoms but also improvement in psychosocial functioning. Clinicians and patients need to become sensitized to the role of social functioning and quality of life in the assessment of treatment outcomes. Although there has been a recent emphasis on the inclusion of social function and quality of life measures in the definition of and requirements for remission, numerous standardized scales for measuring these factors already exist. In addition, selection of efficacious therapeutic agents proven to promote both elimination of symptoms and return to full social functioning is important. Finally, significant improvement in both symptoms and function may be necessary to prevent not only relapse but also ensure full remission of anxiety and depressive disorders.