Clinical depression follow-up
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with clinical depression should be followed-up four to six weeks following the initiation of the treatment to assess for improvement of symptoms and treatment adherence.[1][2] This is based on clinical practice guidelines by the Veteran Affairs/Department of Defense (VA/DoD) and American Psychiatric Association.
Follow-up
The Veteran Affairs/Department of Defense (VA/DoD) clinical practice guidelines for management of major depressive disorder recommends the following regarding the follow-up of patients:[1]
- The follow-up period from the time of initial diagnosis is four to six weeks.
- At time of follow-up, a repeat PHQ-9 and an evaluation of the risk for suicide should be completed in order to assess treatment response.
- How well treatment was tolerated, adherence to treatment, other influential medical problems, and psychosocial barriers to therapy should also be addressed at the time of follow-up.
Evidence
Two randomized controlled trials found improved outcomes using 'measurement-based care' to monitor patients.[3][4]
A more recent systematic review by the Cochrane Collaboration did not find benefit from measurement-based care.[5] However, the Cochrane review did not include the Comet trial and the trial by Guo. Comet was excluded for choice of outcome and Gui was not mentioned by the Cochrane.
References
- ↑ 1.0 1.1 VA/DoD clinical practice guideline for the management of major depressive disorder (MDD). Guideline summary. Washington (DC): Department of Veterans Affairs (U.S.); 2009
- ↑ American Psychiatric Association (APA). Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. Arlington (VA): American Psychiatric Association (APA); 2010 Oct. 152 p. [1170 references] doi:10.1176/appi.books.9780890423387.654001
- ↑ Guo T, Xiang YT, Xiao L, Hu CQ, Chiu HF, Ungvari GS; et al. (2015). "Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters". Am J Psychiatry. 172 (10): 1004–13. doi:10.1176/appi.ajp.2015.14050652. PMID 26315978. Trial registration is not clear
- ↑ Yeung AS, Jing Y, Brenneman SK, Chang TE, Baer L, Hebden T; et al. (2012). "Clinical Outcomes in Measurement-based Treatment (Comet): a trial of depression monitoring and feedback to primary care physicians". Depress Anxiety. 29 (10): 865–73. doi:10.1002/da.21983. PMID 22807244.
- ↑ Kendrick T, El-Gohary M, Stuart B, Gilbody S, Churchill R, Aiken L; et al. (2016). "Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults". Cochrane Database Syst Rev. 7: CD011119. doi:10.1002/14651858.CD011119.pub2. PMID 27409972.