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Research Article

PILOT RANDOMIZED TRIAL OF A CROSS-DIAGNOSIS COLLABORATIVE CARE PROGRAM FOR PATIENTS WITH MOOD DISORDERS

  1. Amy M. Kilbourne Ph.D., M.P.H.1,2,*,
  2. Decartes Li M.D.3,
  3. Zongshan Lai M.S.1,2,
  4. Jeanette Waxmonsky Ph.D.4,
  5. Terrence Ketter M.D.5

Article first published online: 17 OCT 2012

DOI: 10.1002/da.22003

Issue

Depression and Anxiety

Depression and Anxiety

Volume 30, Issue 2, pages 116–122, February 2013

Additional Information

How to Cite

Kilbourne, A. M., Li, D., Lai, Z., Waxmonsky, J. and Ketter, T. (2013), PILOT RANDOMIZED TRIAL OF A CROSS-DIAGNOSIS COLLABORATIVE CARE PROGRAM FOR PATIENTS WITH MOOD DISORDERS. Depress. Anxiety, 30: 116–122. doi: 10.1002/da.22003

Author Information

  1. 1

    VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan

  2. 2

    Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan

  3. 3

    Department of Psychiatry, University of California San Francisco, San Francisco, California

  4. 4

    Department of Psychiatry and Depression Center, University of Colorado, Denver, Colorado

  5. 5

    Department of Psychiatry, Stanford University, Palo Alto, California

*Correspondence to: Amy M. Kilbourne, VA Ann Arbor Center for Clinical Management Research, North Campus Research Complex, 2800 Plymouth Road, Bldg 14, Ann Arbor, MI 48109. E-mail: amykilbo@umich.edu

Publication History

  1. Issue published online: 25 JAN 2013
  2. Article first published online: 17 OCT 2012
  3. Manuscript Accepted: 1 SEP 2012
  4. Manuscript Revised: 28 AUG 2012
  5. Manuscript Received: 15 JUN 2012

Funded by

  • University of Michigan Comprehensive Depressive Center's Director's Innovation Award
  • National Institutes of Mental Health. Grant Numbers: R01 MH79994, MH 74509

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Keywords:

  • mood disorders;
  • collaborative care;
  • self-management

Objectives

Chronic care models improved outcomes for persons with mental disorders but to date have primarily been tested for single diagnoses (e.g. unipolar depression). We report findings from a pilot multisite randomized controlled trial of a cross-diagnosis care model for patients with mood disorders.

Methods

Patients (N = 60) seen in one of four primary care or mental health clinics affiliated with the National Network of Depression Centers were randomized to receive a mood disorder care model, Life Goals Collaborative Care (LGCC, N = 29) or usual care (N = 31). LGCC consisted of five group self-management sessions focused on mood symptom coping and health behavior change strategies followed by monthly patient and provider care management contacts for up to 6 months. Outcomes at 3 and 6 months included mood symptoms (Patient Health Questionnaire—PHQ-9, Internal State Scale—well-being, Generalized Anxiety Disorder scale) and health-related quality of life.

Results

Of the 60 enrolled, the mean age was 46.2 (SD = 13.2), 73.3% were female, 16.7% were non-white, and 36.8% had a bipolar disorder diagnosis. LGCC was associated with greater likelihood of depressive symptom remission in 6 months (respectively, 50% versus 19% had a PHQ-9 score ≤9 and 50% reduction in PHQ-9 score, P = .04) and improved well-being (β = 2.66, P ≤ .01, Cohen's D = 0.43).

Conclusions

LGCC may improve outcomes for patients regardless of mood diagnosis, potentially providing a feasible and generalizable chronic care model for routine practice settings.

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