Peter P Zandi1, Yu-Hsun Wang1, Paresh D Patel1, David Katzelnick1, Carolyn L Turvey1, Jesse H Wright1, Olusola Ajilore1, William Coryell1, Christopher D Schneck1, Constance Guille1, Erika F H Saunders1, Sophie A Lazarus1, Valeria A Cuellar1, Sudhakar Selvaraj1, Patricia Dill Rinvelt1, John F Greden1, J Raymond DePaulo1. 1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt).
Abstract
OBJECTIVES: Mood disorders are among the most burdensome public health concerns. The National Network of Depression Centers (NNDC) is a nonprofit consortium of 26 leading clinical and academic member centers in the United States providing care for patients with mood disorders, including depression and bipolar disorder. The NNDC has established a measurement-based care program called the Mood Outcomes Program whereby participating sites follow a standard protocol to electronically collect patient-reported outcome assessments on depression, anxiety, and suicidal ideation in routine clinical care. This article describes the approaches taken to develop and implement the program. METHODS: Since 2015, eight pilot sites have implemented the program and followed more than 10,000 patients. This pilot study presents descriptive statistics based on the first 24-month period of data collection. RESULTS: In this sample, 58.6% of patients with bipolar disorder (N=849) and 57.5% of patients with unipolar depression (N=3,998) remained symptomatic at follow-up. Lifetime rates of planned or actual suicide attempts were high, ranging from 27.6% for patients with unipolar mood disorders to 33.5% for patients with bipolar disorder. Men, unmarried individuals, and those with comorbid anxiety had a poorer longitudinal course. This initial snapshot of clinical burden is consistent with public health data indicating that mood disorders are severely debilitating. CONCLUSIONS: This study demonstrates the potential of the Mood Outcomes Program to create a nationwide "learning health system" for mood disorders. This goal will be further realized as the program expands in reach and scope across additional NNDC sites.
OBJECTIVES: Mood disorders are among the most burdensome public health concerns. The National Network of Depression Centers (NNDC) is a nonprofit consortium of 26 leading clinical and academic member centers in the United States providing care for patients with mood disorders, including depression and bipolar disorder. The NNDC has established a measurement-based care program called the Mood Outcomes Program whereby participating sites follow a standard protocol to electronically collect patient-reported outcome assessments on depression, anxiety, and suicidal ideation in routine clinical care. This article describes the approaches taken to develop and implement the program. METHODS: Since 2015, eight pilot sites have implemented the program and followed more than 10,000 patients. This pilot study presents descriptive statistics based on the first 24-month period of data collection. RESULTS: In this sample, 58.6% of patients with bipolar disorder (N=849) and 57.5% of patients with unipolar depression (N=3,998) remained symptomatic at follow-up. Lifetime rates of planned or actual suicide attempts were high, ranging from 27.6% for patients with unipolar mood disorders to 33.5% for patients with bipolar disorder. Men, unmarried individuals, and those with comorbid anxiety had a poorer longitudinal course. This initial snapshot of clinical burden is consistent with public health data indicating that mood disorders are severely debilitating. CONCLUSIONS: This study demonstrates the potential of the Mood Outcomes Program to create a nationwide "learning health system" for mood disorders. This goal will be further realized as the program expands in reach and scope across additional NNDC sites.
Entities:
Keywords:
Depression, Administration and management, bipolar disorder; learning health system; meaurement-based care; patient reported outcomes
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