A depressive
exacerbation was determined to have occurred
if: (1) after a period of at least 1 month with all three
depressive items rated below clinical threshold
(below a rating of ‘4’), the patient (i) obtained a
rating of ‘6’ (severe) or ‘7’ (extremely severe) on any
one of the three depressive items during any regular
2-week BPRS-E; (ii) obtained a rating of ‘5’ (moderately
severe) plus a 2-point increase on one of the
other two items during a regular BPRS-E; or (iii)
obtained a rating of ‘5’ on any of the three items for
more than two consecutive administrations of the
BPRS-E; or (2) after ongoing ratings of ‘4’ or above
on one of the BPRS-E depressive items, the patient
later (i) showed a 2-point increase on that item to a
rating of either ‘6’ or ‘7’, or (ii) showed a 1-point
increase to either ‘6’ or ‘7’ plus an accompanying
2-point increase on another depressive item. For
patients with multiple depressive exacerbations, the
first depressive exacerbation was examined.