Random Semantic Question

[The Pride]

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I realize this is not a very sexy question and it has little bearing on anything, but I was bothered by it earlier today and was unable to find the answer in any of my textbooks.

Regarding subclassification of MDD (mild, moderate, severe), are you supposed to classify the patient's mood over the past 2 weeks, over the period until the patient was last symptom-free, over the period until the patient last failed to meet diagnostic criteria, or what?
For example, if u saw a patient who was MDD severe with psychosis a few weeks ago, and then he comes in for follow-up and is much better but still depressed, is it still technically "severe."
And what does it take to call a patient "in remission"?

Much thanks!

 

[OldPsychDoc]

I realize this is not a very sexy question and it has little bearing on anything, but I was bothered by it earlier today and was unable to find the answer in any of my textbooks.

Regarding subclassification of MDD (mild, moderate, severe), are you supposed to classify the patient's mood over the past 2 weeks, over the period until the patient was last symptom-free, over the period until the patient last failed to meet diagnostic criteria, or what?
For example, if u saw a patient who was MDD severe with psychosis a few weeks ago, and then he comes in for follow-up and is much better but still depressed, is it still technically "severe."
And what does it take to call a patient "in remission"?

Much thanks!

Not a random or irrelevant question. It's what we have to put down on our billing forms every day!

The answer is in DSMIV-TR--pp175-6 in my spiral bound edition.
Briefly, it is based on the current severity of symptoms. Remission (partial or full) is based on no longer meeting full criteria for a MDE, but having done so in the past.