Citation

Zandi PP, Wang YH, Patel PD, Katzelnick D, Turvey CL, Wright JH, Ajilore O, Coryell W, Schneck CD, Guille C, Saunders EFH, Lazarus SA, Cuellar VA, Selvaraj S, Dill Rinvelt P, Greden JF, Depaulo JR. Psychiatr. Serv. 2020; ePub(ePub): ePub.

Affiliation

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).

Copyright

(Copyright © 2020, American Psychiatric Association)

DOI

10.1176/appi.ps.201900481

PMID

31960777

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.

Language: en

Keywords

Depression, Administration and management, bipolar disorder; learning health system; meaurement-based care; patient reported outcomes