The Efficacy of Measurement-Based Care for Depressive Disorders

Zhu, Maria; Hong, Ran Ha; Yang, Xingchen; Wang, Xing; Liu, Jing; Murphy, Jill; Michalak, Erin E.; Wang, Zuowei; Yatham, Lakshmi N.; Lam, Raymond W.

doi:10.4088/jcp.21r14034

Cited by 37 publications

(25 citation statements)

References 34 publications

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“…Measurement-based care involves collecting outcome data from individual service users and using these data to inform treatment planning [11,15]. Randomized control trials show significant positive effects of measurement-based care on treatment outcomes of adults receiving psychotherapy [e.g., 11,[16][17][18][19], and antidepressants [20], though the evidence base is less developed for youth [21]. Person-centred care encourages the active engagement of service users in care management, for example through shared decision-making about treatment options [13].…”

Section: Introductionmentioning

confidence: 99%

What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile

Krause

Calderón

Pino

et al. 2023

Eur Child Adolesc Psychiatry

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Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural “super profiles”. We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed.

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Section: Introductionmentioning

confidence: 99%

What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile

Krause

Calderón

Pino

et al. 2023

Eur Child Adolesc Psychiatry

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“…Repeated measurement of symptom severity improves treatment outcomes, 89,90 but time constraints in clinical practice preclude wide use 91 . Additionally, subjective measurement using questionnaires and interviews is prone to bias 1 .…”

Section: Resultsmentioning

confidence: 99%

Applications of Speech Analysis in Psychiatry

Dikaios

Rempel

Dumpala

et al. 2023

Harv Rev Psychiatry

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The need for objective measurement in psychiatry has stimulated interest in alternative indicators of the presence and severity of illness. Speech may offer a source of information that bridges the subjective and objective in the assessment of mental disorders. We systematically reviewed the literature for articles exploring speech analysis for psychiatric applications. The utility of speech analysis depends on how accurately speech features represent clinical symptoms within and across disorders. We identified four domains of the application of speech analysis in the literature: diagnostic classification, assessment of illness severity, prediction of onset of illness, and prognosis and treatment outcomes. We discuss the findings in each of these domains, with a focus on how types of speech features characterize different aspects of psychopathology. Models that bring together multiple speech features can distinguish speakers with psychiatric disorders from healthy controls with high accuracy. Differentiating between types of mental disorders and symptom dimensions are more complex problems that expose the transdiagnostic nature of speech features. Convergent progress in speech research and computer sciences opens avenues for implementing speech analysis to enhance objectivity of assessment in clinical practice. Application of speech analysis will need to address issues of ethics and equity, including the potential to perpetuate discriminatory bias through models that learn from clinical assessment data. Methods that mitigate bias are available and should play a key role in the implementation of speech analysis.

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“…In addition, MBC assists mental health providers in identifying worsening symptoms and treatment inertia, which, if not identified, delays remission (Duffy et al, 2008; Fortney et al, 2017; Guo et al, 2015; Zimmerman et al, 2012). Implementing MBC, specifically in major depressive disorder, has been shown to increase clinical remission rates and decrease endpoint depression severity (Guo et al, 2015; Zhu et al, 2021). Clinical remission is an important outcome because it is associated with a lower risk of relapse and better long-term outcomes (Guo et al, 2015; Zhu et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

The Impact of Measurement-Based Care in Psychiatry: An Integrative Review

DeSimone,

Hansen

2023

J Am Psychiatr Nurses Assoc

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BACKGROUND: The quality of mental health treatment has not progressed to the same extent as physical health treatment. Suboptimal mental health outcomes may be attributed to the lack of a systematic approach to tracking and measuring patient progress. In psychiatry, Measurement-Based Care (MBC) offers an objective, systematic approach to monitor clinical progress, evaluate treatment efficacy, and inform clinical decisions, yet remains seldom used in daily practice. AIMS: To identify the clinical impact of using MBC in psychiatry. METHODS: Using the Johns Hopkins Nursing Evidence-Based Practice Model as a guideline, this integrative review focused on the research query, “What is the clinical impact of Measurement-Based Care when treating patients with mental illness?” RESULTS: A total of nine articles met the inclusion criteria for this integrative review. The articles ranged from 2008 to 2021. The following themes were identified from the analysis of these articles: (1) the clinical impact of MBC, (2) provider attitudes about MBC, and (3) barriers to MBC implementation. CONCLUSIONS: MBC, augmenting usual standard care, provides an objective, systematic approach using quantifiable data to monitor symptom severity and treatment effectiveness. This review highlights the clinical benefits of MBC, including increased remission rates, lower risk of relapse, improved medication adherence, and strengthening the therapeutic alliance. Although this review provides an overview of the benefits of MBC in psychiatry, there remains a substantial practice gap warranting further investigation. Strategies must be developed to address barriers at the individual and organizational levels which impede the successful adoption of MBC.

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The Efficacy of Measurement-Based Care for Depressive Disorders

Cited by 37 publications

References 34 publications

What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile

What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile

Applications of Speech Analysis in Psychiatry

The Impact of Measurement-Based Care in Psychiatry: An Integrative Review

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