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Find video protocols related to scientific articles indexed in Pubmed.
Long-Term Clinical Outcomes from a Randomized Controlled Trial of Two Implementation Strategies to Promote Collaborative Care Attendance in Community Practices.
Adm Policy Ment Health
PUBLISHED: 10-16-2014
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This randomized controlled implementation study compared the effectiveness of a standard versus enhanced version of the replicating effective programs (REP) implementation strategy to improve the uptake of the life goals-collaborative care model (LG-CC) for bipolar disorder. Seven community-based practices (384 patient participants) were randomized to standard (manual/training) or enhanced REP (customized manual/training/facilitation) to promote LG-CC implementation. Participants from enhanced REP sites had no significant changes in primary outcomes (improved quality of life, reduced functioning or mood symptoms) by 24 months. Further research is needed to determine whether implementation strategies can lead to sustained, improved participant outcomes in addition to program uptake.
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Enhanced fidelity to treatment for bipolar disorder: results from a randomized controlled implementation trial.
Psychiatr Serv
PUBLISHED: 09-25-2014
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The authors compared fidelity to bipolar disorder treatment at community practices that received a standard or enhanced version of a novel implementation intervention called Replicating Effective Programs (REP).
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Self-management and bipolar disorder--a clinician's guide to the literature 2011-2014.
Curr Psychiatry Rep
PUBLISHED: 08-16-2014
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This review provides clinicians and individuals with bipolar disorder (BD) with an overview of evidence-based skills shown to be effective in BD and amenable to self-management including psychoeducation; monitoring moods, medications, and social function; sleep hygiene; setting goals and relapse plans; and healthy lifestyles (physical activity, healthy eating, weight loss and management, medical comorbidities). Currently available self-management resources for BD are summarized by mode of delivery (workbooks, mobile technologies, internet, and peer-led interventions). Regardless of the self-management intervention/topic, the research suggests that personally tailored interventions of longer duration and greater frequency may be necessary to achieve the maximal benefit among individuals with BD. Means to support these self-management interventions as self-sustaining identities are critically needed. Hopefully, the recent investment in patient-centered research and care will result in best practices for the self-management of BD by mode of delivery. Since self-management of BD should complement rather than replace medical care, clinicians need to partner with their patients to incorporate and support advances in self-management for individuals with BD.
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Weight Loss After Participation in a National VA Weight Management Program Among Veterans With or Without PTSD.
Psychiatr Serv
PUBLISHED: 08-15-2014
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This evaluation compared the effectiveness of MOVE!, a U.S. Veterans Health Administration (VHA) weight management program, among veterans with posttraumatic stress disorder (PTSD), other mental conditions, or no mental health diagnoses.
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Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.
Implement Sci
PUBLISHED: 08-08-2014
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Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months.
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Self-efficacy and quality of life among people with bipolar disorder.
J. Nerv. Ment. Dis.
PUBLISHED: 07-11-2014
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People with bipolar disorders report a lower quality of life than the general population does, and few mutable factors associated with health-related quality of life (HRQoL) among people with bipolar disorders have been identified. Using a cross-sectional design, these analyses examined whether self-efficacy was associated with mental and physical HRQoL in a sample of 141 patients with bipolar disorder who completed baseline assessments for two randomized controlled trials. Multiple linear regression analyses indicated that higher levels of self-efficacy were associated with higher mental and physical HRQoL, after controlling for demographic factors and clinical factors (including mood symptoms, comorbid medical conditions, and substance use). Future research should examine whether targeted treatments that aim to improve self-efficacy (such as self-management interventions) lead to improvements in HRQoL among people with bipolar disorder and other serious mental illnesses.
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SMI life goals: description of a randomized trial of a collaborative care model to improve outcomes for persons with serious mental illness.
Contemp Clin Trials
PUBLISHED: 05-16-2014
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Persons with serious mental illnesses (SMI) are more likely to die earlier than the general population, primarily due to increased medical burden, particularly from cardiovascular disease (CVD). Life Goals Collaborative Care (LG-CC) is designed to improve health outcomes in SMI through self-management, care management, and provider support. This single-blind randomized controlled effectiveness study will determine whether patients with SMI receiving LG-CC compared to usual care (UC) experience improved physical health in 12 months.
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Demographic and clinical differences between early- and late-onset major depressions in thirteen psychiatric institutions in China.
J Affect Disord
PUBLISHED: 05-09-2014
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Little is known about the demographic and clinical differences between early- and late-onset depressions (EOD and LOD, respectively) in Chinese patients. This study examined the demographic and clinical profile of EOD (<=25 years) compared to LOD (>25 years) in China.
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Diagnostic accuracy of the Composite International Diagnostic Interview (CIDI 3.0) PTSD module among female Vietnam-era veterans.
J Trauma Stress
PUBLISHED: 04-18-2014
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The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) posttraumatic stress disorder (PTSD) module is widely used in epidemiological studies of PTSD, yet relatively few data attest to the instrument's diagnostic utility. The current study evaluated the diagnostic utility of the CIDI 3.0 PTSD module with U. S. women Vietnam-era veterans. The CIDI and the Clinician-Administered PTSD Scale (CAPS) were independently administered to a stratified sample of 160 women, oversampled for current PTSD. Both lifetime PTSD and recent (past year) PTSD were assessed within a 3-week interval. Forty-five percent of the sample met criteria for a CAPS diagnosis of lifetime PTSD, and 21.9% of the sample met criteria for a CAPS diagnosis of past-year PTSD. Using CAPS as the diagnostic criterion, the CIDI correctly classified 78.8% of cases for lifetime PTSD (? = .56) and 82.0% of past year PTSD cases (? = .51). Estimates of diagnostic performance for the CIDI were sensitivity of .61 and specificity of .91 for lifetime PTSD and sensitivity of .71 and specificity of .85 for past-year PTSD. Results suggest that the CIDI has good utility for identifying PTSD, though it is a somewhat conservative indicator of lifetime PTSD as compared to the CAPS.
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Collaborative care outcomes for pediatric behavioral health problems: a cluster randomized trial.
Pediatrics
PUBLISHED: 03-24-2014
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To assess the efficacy of collaborative care for behavior problems, attention-deficit/hyperactivity disorder (ADHD), and anxiety in pediatric primary care (Doctor Office Collaborative Care; DOCC).
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HealthViEWS: mortality study of female US Vietnam era veterans, 1965-2010.
Am. J. Epidemiol.
PUBLISHED: 01-30-2014
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We conducted a retrospective study among 4,734 women who served in the US military in Vietnam (Vietnam cohort), 2,062 women who served in countries near Vietnam (near-Vietnam cohort), and 5,313 nondeployed US military women (US cohort) to evaluate the associations of mortality outcomes with Vietnam War service. Veterans were identified from military records and followed for 40 years through December 31, 2010. Information on underlying causes of death was obtained from death certificates and the National Death Index. Based on 2,743 deaths, all 3 veteran cohorts had lower mortality risk from all causes combined and from several major causes, such as diabetes mellitus, heart disease, chronic obstructive pulmonary disease, and nervous system disease relative to comparable US women. However, excess deaths from motor vehicle accidents were observed in the Vietnam cohort (standardized mortality ratio = 3.67, 95% confidence interval (CI): 2.30, 5.56) and in the US cohort (standardized mortality ratio = 1.91, 95% CI: 1.02, 3.27). More than two-thirds of women in the study were military nurses. Nurses in the Vietnam cohort had a 2-fold higher risk of pancreatic cancer death (adjusted relative risk = 2.07, 95% CI: 1.00, 4.25) and an almost 5-fold higher risk of brain cancer death compared with nurses in the US cohort (adjusted relative risk = 4.61, 95% CI: 1.27, 16.83). Findings of all-cause and motor vehicle accident deaths among female Vietnam veterans were consistent with patterns of postwar mortality risk among other war veterans.
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Tablet-based screening of depressive symptoms in quito, ecuador: efficiency in primary care.
Int J Family Med
PUBLISHED: 01-01-2014
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Depression is a frequent yet overlooked occurrence in primary health care clinics worldwide. Depression and related health screening instruments are available but are rarely used consistently. The availability of technologically based instruments in the assessments offers novel approaches for gathering, storing, and assessing data that includes self-reported symptom severity from the patients themselves as well as clinician recorded information. In a suburban primary health care clinic in Quito, Ecuador, we tested the feasibility and utility of computer tablet-based assessments to evaluate clinic attendees for depression symptoms with the goal of developing effective screening and monitoring tools in the primary care clinics. We assessed individuals using the 9-item Patient Health Questionnaire, the Quick Inventory of Depressive Symptoms-Self-Report, the 12-item General Health Questionnaire, the Clinical Global Impression Severity, and a DSM-IV checklist of symptoms. We found that 20% of individuals had a PHQ9 of 8 or greater. There was good correlation between the symptom severity assessments. We conclude that the tablet-based PHQ9 is an excellent and efficient method of screening for depression in attendees at primary health care clinics and that one in five people should be assessed further for depressive illness and possible intervention.
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Randomized controlled trial to assess reduction of cardiovascular disease risk in patients with bipolar disorder: the Self-Management Addressing Heart Risk Trial (SMAHRT).
J Clin Psychiatry
PUBLISHED: 08-16-2013
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Persons with bipolar disorder experience a disproportionate burden of medical conditions, notably cardiovascular disease (CVD), leading to impaired functioning and premature mortality. We hypothesized that the Life Goals Collaborative Care (LGCC) intervention, compared to enhanced usual care, would reduce CVD risk factors and improve physical and mental health outcomes in US Department of Veterans Affairs patients with bipolar disorder.
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Collaborative chronic care models for mental health conditions: cumulative meta-analysis and metaregression to guide future research and implementation.
Med Care
PUBLISHED: 08-14-2013
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Prior meta-analysis indicates that collaborative chronic care models (CCMs) improve mental and physical health outcomes for individuals with mental disorders. This study aimed to investigate the stability of evidence over time and identify patient and intervention factors associated with CCM effects to facilitate implementation and sustainability of CCMs in clinical practice.
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A comparison of cognitive-behavioral therapy, antidepressants, their combination and standard treatment for Chinese patients with moderate-severe major depressive disorders.
J Affect Disord
PUBLISHED: 07-31-2013
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No study has examined the effect of cognitive-behavioral therapy (CBT) on moderate-severe major depressive disorders (MDD) in China. The objective of this study was to evaluate the effect of CBT, antidepressants alone (MED), combined CBT and antidepressants (COMB) and standard treatment (ST; i.e., receiving psycho-educational intervention and/or medication treatment determined by treating psychiatrists) on depressive symptoms and social functioning in Chinese patients with moderate-severe MDD.
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Mental health collaborative care and its role in primary care settings.
Curr Psychiatry Rep
PUBLISHED: 07-25-2013
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Collaborative care models (CCMs) provide a pragmatic strategy to deliver integrated mental health and medical care for persons with mental health conditions served in primary care settings. CCMs are team-based intervention to enact system-level redesign by improving patient care through organizational leadership support, provider decision support, and clinical information systems, as well as engaging patients in their care through self-management support and linkages to community resources. The model is also a cost-efficient strategy for primary care practices to improve outcomes for a range of mental health conditions across populations and settings. CCMs can help achieve integrated care aims underhealth care reform yet organizational and financial issues may affect adoption into routine primary care. Notably, successful implementation of CCMs in routine care will require alignment of financial incentives to support systems redesign investments, reimbursements for mental health providers, and adaptation across different practice settings and infrastructure to offer all CCM components.
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Cluster randomized adaptive implementation trial comparing a standard versus enhanced implementation intervention to improve uptake of an effective re-engagement program for patients with serious mental illness.
Implement Sci
PUBLISHED: 07-17-2013
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Persons with serious mental illness are disproportionately burdened by premature mortality. This disparity is exacerbated by poor continuity of care with the health system. The Veterans Health Administration (VA) developed Re-Engage, an effective population-based outreach program to identify veterans with SMI lost to care and to reconnect them with VA services. However, such programs often encounter barriers getting implemented into routine care. Adaptive designs are needed when the implementation intervention requires augmentation within sites that do not initially respond to an initial implementation intervention. This protocol describes the methods used in an adaptive implementation design study that aims to compare the effectiveness of a standard implementation strategy (Replicating Effective Programs, or REP) with REP enhanced with External Facilitation (enhanced REP) to promote the uptake of Re-Engage.Methods/design: This study employs a four-phase, two-arm, longitudinal, clustered randomized trial design. VA sites (n = 158) across the United States with a designated Re-Engage provider, at least one Veteran with SMI lost to care, and who received standard REP during a six-month run-in phase. Subsequently, 88 sites with inadequate uptake were stratified at the cluster level by geographic region (n = 4) and VA regional service network (n = 20) and randomized to REP (n = 49) vs. enhanced REP (n = 39) in phase two. The primary outcome was the percentage of veterans on each facility outreach list documented on an electronic web registry. The intervention was at the site and network level and consisted of standard REP versus REP enhanced by external phone facilitation consults. At 12 months, enhanced REP sites returned to standard REP and 36 sites with inadequate participation received enhanced REP for six months in phase three. Secondary implementation outcomes included the percentage of veterans contacted directly by site providers and the percentage re-engaged in VA health services.
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Health care utilization prior to loss to care among veterans with serious mental illness.
Psychiatr Serv
PUBLISHED: 06-04-2013
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This study examined the association between utilization of Veterans Affairs (VA) health services and the probability of treatment dropout among veterans with serious mental illness.
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An evidence synthesis of care models to improve general medical outcomes for individuals with serious mental illness: a systematic review.
J Clin Psychiatry
PUBLISHED: 05-21-2013
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To conduct a systematic review of studies of interventions that integrated medical and mental health care to improve general medical outcomes in individuals with serious mental illness.
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Overcoming roadblocks: current and emerging reimbursement strategies for integrated mental health services in primary care.
J Gen Intern Med
PUBLISHED: 05-03-2013
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The Chronic Care Model (CCM) has been shown to improve medical and psychiatric outcomes for persons with mental disorders in primary care settings, and has been proposed as a model to integrate mental health care in the patient-centered medical home under healthcare reform. However, the CCM has not been widely implemented in primary care settings, primarily because of a lack of a comprehensive reimbursement strategy to compensate providers for day-to-day provision of its core components, including care management and provider decision support. Drawing upon the existing literature and regulatory guidelines, we provide a critical analysis of challenges and opportunities in reimbursing CCM components under the current fee-for-service system, and describe an emerging financial model involving bundled payments to support core CCM components to integrate mental health treatment into primary care settings. Ultimately, for the CCM to be used and sustained over time to integrate physical and mental health care, effective reimbursement models will need to be negotiated across payers and providers. Such payments should provide sufficient support for primary care providers to implement practice redesigns around core CCM components, including care management, measurement-based care, and mental health specialist consultation.
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Gender differences in demographic and clinical features and prescribing patterns of psychotropic medications in patients with major depressive disorder in China.
Compr Psychiatry
PUBLISHED: 04-09-2013
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Little is known about gender differences associated with major depressive disorder (MDD) in China. This study examined gender differences associated with other demographic and clinical characteristics and psychotropic drug treatment in Chinese patients with MDD.
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Antipsychotic prescribing pathways, polypharmacy, and clozapine use in treatment of schizophrenia.
Psychiatr Serv
PUBLISHED: 03-02-2013
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To ensure optimal care for patients with schizophrenia, antipsychotic medications must be appropriately prescribed and used. Therefore, the primary objectives of this study were to identify and describe pathways for antipsychotic prescribing, assess the consistency of observed pathways with treatment guidelines, and describe variability across facilities.
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Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China.
Bipolar Disord
PUBLISHED: 02-27-2013
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Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China.
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Associations of self-esteem, dysfunctional beliefs and coping style with depression in patients with schizophrenia: a preliminary survey.
Psychiatry Res
PUBLISHED: 02-03-2013
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Psychological models of depression in schizophrenia have proposed that cognitive structures (e.g., self-esteem, dysfunctional beliefs) may have a role in the development and maintenance of depression. However, it has not been clear what the characteristics of these cognitive structures were in people with schizophrenia and whether they have an independent association with depression, especially in those from a Chinese cultural background. The present investigation examined 133 people with schizophrenia and 50 healthy controls and indicated that compared to the controls people with schizophrenia showed lower self-esteem, higher levels of dysfunctional beliefs and negative coping styles. Multiple linear regression analysis revealed that only low frustration tolerance, problem solving and self-blame were found to be the independent correlates of depression in schizophrenia. Results are discussed with the view of clinical implications of cognitive formulation and therapy for schizophrenia in China.
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Pain conditions among veterans with schizophrenia or bipolar disorder.
Gen Hosp Psychiatry
PUBLISHED: 01-15-2013
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The purpose of this study was to assess the rates of chronic, noncancer pain conditions in patients with schizophrenia or bipolar disorder within the Veterans Health Administration (VHA) System.
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Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial.
Arch Pediatr Adolesc Med
PUBLISHED: 11-07-2011
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To evaluate the feasibility and clinical benefits of an integrated mental health intervention (doctor-office collaborative care [DOCC]) vs enhanced usual care (EUC) for children with behavioral problems.
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Quality of general medical care among patients with serious mental illness: does colocation of services matter?
Psychiatr Serv
PUBLISHED: 08-03-2011
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This study was conducted to determine whether patients with serious mental illness receiving care in Veterans Affairs (VA) mental health programs with colocated general medical clinics were more likely to receive adequate medical care than patients in programs without colocated clinics based on a nationally representative sample.
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Development and implementation of collaborative care for depression in HIV clinics.
AIDS Care
PUBLISHED: 06-30-2011
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We sought to develop and implement collaborative depression care in human immunodeficiency virus (HIV) clinics in a project called HIV Translating Initiatives for Depression into Effective Solutions (HITIDES). Here we describe: (i) the formative evaluation (FE) conducted prior to implementation; (ii) the process used to adapt the primary care collaborative care model for depression to specialty HIV clinics; and (iii) the intervention itself. The overall design of HITIDES was a multi-site randomized trial in United States Department of Veterans Affairs (VA) HIV clinics comparing the depression collaborative care intervention to usual depression care. Qualitative methods were used for the FEs and informed the evidence-based quality improvement (EBQI) methods that were used for adapting and implementing the intervention. Baseline assessments were completed by 249 depressed HIV participants. Summaries of respective key informant interviews with eight HIV patients who were receiving depression treatment and 25 HIV or mental health (MH) providers were presented to each site. EBQI methods were used to tailor the HITIDES intervention to each site while maintaining true to the evidence base for depression collaborative care. EBQI methods provided a useful framework for intervention adaptation and implementation. The HITIDES study provides the opportunity to evaluate collaborative depression care in a specialty physical health clinic setting with a population that has a high prevalence of depression and MH comorbidity.
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Colocated general medical care and preventable hospital admissions for veterans with serious mental illness.
Psychiatr Serv
PUBLISHED: 05-03-2011
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This study examined whether veterans with serious mental illness in mental health settings with colocated general medical care had fewer hospitalizations for ambulatory care-sensitive conditions than veterans in other settings.
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Does colocated care improve access to cardiometabolic screening for patients with serious mental illness?
Gen Hosp Psychiatry
PUBLISHED: 04-09-2011
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Individuals with serious mental illness (SMI; e.g., schizophrenia, bipolar disorder) experience disparities in mortality relative to the general population, mainly because of medical conditions (i.e., cardiometabolic disease).We assessed whether VA patients with SMI and receiving care from VA mental health facilities with colocated medical care were more likely to receive cardiometabolic risk assessments in accordance with clinical practice guidelines than patients from noncolocated facilities.
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Ratings of patient-provider communication among veterans: serious mental illnesses, substance use disorders, and the moderating role of trust.
Health Commun
PUBLISHED: 03-11-2011
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Many individuals with a mental illness are not satisfied with their communication with their primary provider. The present study examined the relationship of serious mental illness (SMI), substance use disorder (SUD), and trust for the provider with provider communication. The sample included Veterans Administration (VA) patients throughout the United States who either had a SMI diagnosis (schizophrenia or bipolar disorder) or were in a random sample of non-SMI patients (total N=8,089). Latent class (LC) modeling identified three classes of provider communication ratings in the sample: very good, good, and poor. In LC regression, poor trust for the provider was associated with a decrease in the likelihood of being in the "very good" or "good" compared to the "poor" provider communication ratings group, and the decrease was significantly greater for VA patients with a SMI or SUD diagnosis than those without. Training providers on creating trust is particularly important for those who serve patients with SMI and SUD diagnoses.
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Effectiveness of collaborative care for depression in human immunodeficiency virus clinics.
Arch. Intern. Med.
PUBLISHED: 01-12-2011
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Depression is common among persons with the human immunodeficiency virus (HIV) and is associated with unfavorable outcomes.
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Employment status of patients in the VA health system: implications for mental health services.
Psychiatr Serv
PUBLISHED: 01-07-2011
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Most veterans who use Department of Veterans Affairs (VA) health care are not employed. This study evaluated the association between mental disorders and labor force status among VA health care users.
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Access-related measures and out-of-system utilization among veterans with bipolar disorder.
Psychiatr Serv
PUBLISHED: 10-05-2010
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This study examined associations between access-related measures and out-of-system health services utilization (general medicine and mental health services) among patients with bipolar disorder at a U.S. Department of Veterans Affairs (VA) medical center.
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Challenges and opportunities in measuring the quality of mental health care.
Can J Psychiatry
PUBLISHED: 09-16-2010
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The purpose of our paper is to delineate the barriers to mental health quality measurement, and to identify strategies to enhance the development and use of quality measures by mental health providers, programs, payers, and other stakeholders in the service of improving outcomes for people with mental health and substance use disorders. Key reasons for the lag in mental health performance measurement include lack of sufficient evidence regarding appropriate mental health care, poorly defined quality measures, limited descriptions of mental health services from existing clinical data, and lack of linked electronic health information. We discuss strategies for overcoming these barriers that are being implemented in several countries, including the need to have quality improvement as part of standard clinical training curricula, refinement of technologies to promote adequate data capture of mental health services, use of incentives to promote provider accountability for improving care, and the need for mental health researchers to improve the evidence base for mental health treatment.
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Severe pain predicts greater likelihood of subsequent suicide.
Suicide Life Threat Behav
PUBLISHED: 08-09-2010
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Using data from the 1999 Large Health Survey of Veterans, Veterans Affairs medical records, and the National Death Index (N = 260,254), the association between self-reported pain severity and suicide among veterans as examined, after accounting for demographic variables and psychiatric diagnoses. A Cox proportional hazards regression demonstrated that veterans with severe pain were more likely to die by suicide than patients experiencing none, mild, or moderate pain (HR: 1.33; 95% CI: 1.15, 1.54), after controlling for demographic and psychiatric characteristics. These results indicate that pain evaluations should be included in comprehensive suicide assessments and suicide prevention efforts.
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Implementing composite quality metrics for bipolar disorder: towards a more comprehensive approach to quality measurement.
Gen Hosp Psychiatry
PUBLISHED: 05-10-2010
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We implemented a set of processes of care measures for bipolar disorder that reflect psychosocial, patient preference and continuum of care approaches to mental health, and examined whether veterans with bipolar disorder receive care concordant with these practices.
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Characteristics of patients with bipolar disorder managed in VA primary care or specialty mental health care settings.
Psychiatr Serv
PUBLISHED: 05-05-2010
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This study compared the clinical characteristics, use of guideline-concordant pharmacotherapy, and outcomes of patients diagnosed as having bipolar disorder who were exclusively seen in Department of Veteran Affairs (VA) primary care settings with those of patients with bipolar disorder who received any VA mental health services.
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Consequences of receipt of a psychiatric diagnosis for completion of college.
Psychiatr Serv
PUBLISHED: 04-03-2010
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The purpose of this study was to evaluate the independent associations between DSM-IV psychiatric disorders and the failure to complete college among college entrants.
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Anticonvulsant use, bipolar disorder, and risk of fracture among older adults in the Veterans Health Administration.
Am J Geriatr Psychiatry
PUBLISHED: 03-13-2010
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To investigate the association between anticonvulsant use and fracture risk among older patients, including those with bipolar disorder (BD), an indicated condition for treatment with this class of medications.
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Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.
J Altern Complement Med
PUBLISHED: 03-03-2010
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Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder.
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Access to weight loss counseling services among patients with bipolar disorder.
J Affect Disord
PUBLISHED: 02-16-2010
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Cardiovascular disease is the leading cause of mortality in persons with bipolar disorder but little is known about utilization of services for risk reduction. We assessed determinants of access to weight counseling in a sample of patients with bipolar disorder.
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The relationship between religious involvement and clinical status of patients with bipolar disorder.
Bipolar Disord
PUBLISHED: 02-13-2010
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Religion and spirituality are important coping strategies in depression but have been rarely studied within the context of bipolar disorder. The present study assessed the association between different forms of religious involvement and the clinical status of individuals treated for bipolar disorder.
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Racial/Ethnic group differences in bipolar symptomatology in a community sample of persons with bipolar I disorder.
J. Nerv. Ment. Dis.
PUBLISHED: 01-12-2010
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To better understand the problems associated with diagnosis of bipolar disorder, especially problems related to race and ethnicity, this study compared whites, African Americans, and Latinos with bipolar I disorder in the presentation of manic symptoms, depressive episodes, functional impairments (Short Form-12), and self-reports of schizophrenia diagnosis. Data for this study were derived from the 2001 National Epidemiologic Survey on Alcohol and Related Conditions, which are nationally representative of United States households. African Americans and Latinos expressed similar rates in presentation of 14 out of 16 manic symptoms compared with whites, with the exception of grandiosity/self-esteem, in which they were more likely to exhibit this symptom compared with whites. Higher rates of depressive episodes were observed among whites, and these episodes occurred significantly earlier compared with African Americans and Latinos. Latinos had slightly higher vitality scores on the SF-12 measures after adjusting for sociodemographic and clinical factors, but no other differences across the groups were observed. Overall, these data show that the expression and functional impairments of bipolar I disorder is very similar across racial ethnic groups using this community-based sample. This is the first community-based study making such comparisons, with results suggesting that provider biases are more likely to explain problems in misdiagnosis than fundamental differences in the presentation of bipolar disorder across racial/ethnic groups.
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Prevalence and burden of general medical conditions among adults with bipolar I disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
J Clin Psychiatry
PUBLISHED: 11-13-2009
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To examine the prevalence and burden of general medical conditions (GMCs) among a nationally representative sample of adults with bipolar I disorder.
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Profiles of disability among adults with bipolar spectrum disorders.
Soc Psychiatry Psychiatr Epidemiol
PUBLISHED: 10-01-2009
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Heterogeneous groups of patients with a spectrum of service needs are commonplace in mental health settings. Although comprehensive assessments are available to measure variations in service needs, numerous challenges still exist when confronting this heterogeneity and many assessments used in clinic settings are lengthy and have not been demonstrated to be consistent over time.
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Enhancing multiyear guideline concordance for bipolar disorder through collaborative care.
Am J Psychiatry
PUBLISHED: 10-01-2009
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Implementation of evidence-based care for serious mental illnesses such as bipolar disorder has been suboptimal. Improving and sustaining concordance with clinical practice guidelines has been a cornerstone of efforts to enhance evidence-based care and improve outcomes. For bipolar disorder, however, there has been only one regional controlled trial reporting guideline concordance, and no data are available for time periods longer than 1 year. In a multiregion effectiveness trial in veterans with bipolar disorder, the authors assessed the effects of a collaborative care model for this disorder on guideline concordance in care over a 3-year period.
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A brief measure of perceived clinician support by patients with bipolar spectrum disorders.
J. Nerv. Ment. Dis.
PUBLISHED: 08-18-2009
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The quality of the patient-provider relationship is regarded as an essential ingredient in the treatment of serious mental illnesses, and is associated with favorable outcomes including improved treatment adherence. However, monitoring the strength and influence of provider support in clinical settings is challenged by the absence of brief, psychometrically sound, and easily administered assessments. The purpose of this study was to test the factor structure and examine the clinical and psychosocial correlates of a brief measure of provider support. Participants were recruited from the continuous improvement for veterans in care-Mood Disorders study (N = 429). The hypothesized factor structure exhibited a good fit with the data. At baseline, provider support was associated with higher levels of service access and medication compliance and lower levels of alcohol use and suicidality. Regular monitoring of provider support may provide useful when tailoring psychosocial treatment strategies, especially in routine care settings.
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A prospective study of the impact of comorbid medical disease on bipolar disorder outcomes.
J Affect Disord
PUBLISHED: 08-12-2009
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Several studies suggest that medical comorbidity is associated with worse clinical status in bipolar disorder. It is unclear which aspect of medical comorbidity is responsible: simple disease count, risk for future morbidity, or current physical burden.
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Organizational contexts of primary care approaches for managing problem drinking.
J Subst Abuse Treat
PUBLISHED: 08-11-2009
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Little is known about the organizational contexts associated with different primary care (PC) approaches to managing PC patients with drinking problems. Relying upon the Chronic Care Model and a theoretically based taxonomy of health care systems, we identified organizational factors distinguishing PC practices using PC-based approaches (managed by PC providers, mental health specialists, or jointly with specialty services) versus referral-based management in the Veterans Affairs health care system. Data were obtained from a national survey of 218 PC practices characterizing usual management approaches as well as practices leadership, delivery system design, information system, and decision support characteristics and from a national survey of substance use disorder specialty programs. PC- and referral-based practices did not differ on the sufficiency of their structural resources, physician staffing, or on the availability of specialty services. However, PC-based practices were found to take more responsibility for managing patients chronic conditions and had more staff for decision support activities.
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Co-occurring conditions and health-related quality of life in patients with bipolar disorder.
Psychosom Med
PUBLISHED: 08-06-2009
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To assess changes in health-related quality of life (HRQOL) and to determine whether co-occurring substance use and medical comorbidities were associated with worse HRQOL over a 1-year period in a naturalistic sample of patients with bipolar disorder.
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Bipolar disorder center for Pennsylvanians: implementing an effectiveness trial to improve treatment for at-risk patients.
Psychiatr Serv
PUBLISHED: 07-01-2009
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Adolescents, elderly persons, African Americans, and rural residents with bipolar disorder are less likely than their middle-aged, white, urban counterparts to be diagnosed, receive adequate treatment, remain in treatment once identified, and have positive outcomes. The Bipolar Disorder Center for Pennsylvanians (BDCP) study was designed to address these disparities. This report highlights the methods used to recruit, screen, and enroll a cohort of difficult-to-recruit individuals with bipolar disorder.
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A collaborative therapeutic relationship and risk of suicidal ideation in patients with bipolar disorder.
J Affect Disord
PUBLISHED: 06-26-2009
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A diagnosis of Bipolar Disorder (BD) is among the strongest known risk factors for suicide. The present study examines the relative impact of current mood state (depressed, manic or mixed) and patient perceptions of the therapeutic relationship on suicidal ideation in veterans with BD.
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Is the collaborative chronic care model effective for patients with bipolar disorder and co-occurring conditions?
J Affect Disord
PUBLISHED: 05-28-2009
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The effectiveness of bipolar collaborative chronic care models (B-CCMs) among those with co-occurring substance use, psychiatric, and/or medical conditions has not specifically been assessed. We assessed whether B-CCM effects are equivalent comparing those with and without co-occurring conditions.
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Access to conventional mental health and medical care among users of complementary and alternative medicine with bipolar disorder.
J. Nerv. Ment. Dis.
PUBLISHED: 04-14-2009
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This research examined the role of perceived barriers to treatment as a potential contributor to the increasing use of complementary and alternative medicine (CAM) among mentally ill populations. The study examined a sample of 435 patients receiving care through the Veterans Administration Health System and having a current diagnosis of bipolar disorder (I, II, NOS), cyclothymia, or schizoaffective disorder-bipolar subtype. Access to care and use of any of 14 CAM therapies within the past year were studied. Physical CAM users reported slightly better mental health service access related to getting to mental health services and obtaining emergency mental health services when needed. Effect sizes for these differences were small (r(pb) = 0.09 and 0.13, respectively). Similarly, oral and cognitive CAM users indicated that they were slightly more likely to go without medical services when needed because they were too expensive. These effect sizes were also very small (r(pb) = 0.12 and 0.10, respectively), suggesting no clinical significance. Patients who reported use of oral and/or cognitive CAM therapies were slightly more likely than nonusers to go without medical care because of excessive costs. Patients having non-Veterans Affairs insurance reported no differences in rates of CAM use. Overall, no discernable trends were observed to suggest that CAM use among this sample was associated with service access.
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Clinical and demographic factors associated with homelessness and incarceration among VA patients with bipolar disorder.
Am J Public Health
PUBLISHED: 03-19-2009
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We assessed the association between homelessness and incarceration in Veterans Affairs patients with bipolar disorder.
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Excess heart-disease-related mortality in a national study of patients with mental disorders: identifying modifiable risk factors.
Gen Hosp Psychiatry
PUBLISHED: 02-25-2009
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People with mental disorders are estimated to die 25 years younger than the general population, and heart disease (HD) is a major contributor to their mortality. We assessed whether Veterans Affairs (VA) health system patients with mental disorders were more likely to die from HD than patients without these disorders, and whether modifiable factors may explain differential mortality risks.
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Predictors of nonadherence among individuals with bipolar disorder receiving treatment in a community mental health clinic.
Compr Psychiatry
PUBLISHED: 02-17-2009
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Subjective experience of illness is a critical component of treatment adherence in populations with bipolar disorder (BPD). This cross-sectional analysis examined clinical and subjective variables in relation to adherence in 140 individuals with BPD receiving treatment with mood-stabilizing medication.
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Understanding associations between serious mental illness and hepatitis C virus among veterans: a national multivariate analysis.
Psychosomatics
PUBLISHED: 02-14-2009
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Hepatitis C virus (HCV) is a leading cause of hepatocellular carcinoma and cirrhosis in the United States and is known to be transmitted via pathways associated with substance use (e.g., injection drug use and intranasal drug use).
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Perceived access to general medical and psychiatric care among veterans with bipolar disorder.
Am J Public Health
PUBLISHED: 01-15-2009
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We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services.
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Life Goals Collaborative Care for patients with bipolar disorder and cardiovascular disease risk.
Psychiatr Serv
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This pilot study compared Life Goals Collaborative Care (LGCC) with enhanced treatment as usual in reducing cardiometabolic risk factors and improving outcomes for persons with bipolar disorder.
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Integrated care, recovery-consistent care features, and quality of life for patients with serious mental illness.
Psychiatr Serv
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The goal of this study was to evaluate relationships between recovery-supportive and integrated care features with health-related quality of life for veterans with serious mental illness.
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Pilot randomized trial of a cross-diagnosis collaborative care program for patients with mood disorders.
Depress Anxiety
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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.
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Leading from the middle: replication of a re-engagement program for veterans with mental disorders lost to follow-up care.
Depress Res Treat
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Objectives. Persons with mental disorders experience functional impairments and premature mortality. Limited continuity of care may contribute to disparities in this group. We describe the replication of an evidence-based outreach program (Re-Engage) to reconnect Veterans with mental disorders into care who have dropped out of services. Methods. Using the Enhanced Replicating Effective Programs framework, population-based registries were used to identify Veterans lost-to-care, and providers used this information to determine Veteran disposition and need for care. Providers recorded Veteran preferences, health status, and care utilization, and formative process data was collected to document implementation efforts. Results. Among Veterans who dropped out of care (n = 126), the mean age was 49 years, 10% were women, and 29% were African-American. Providers determined that 39% of Veterans identified for re-engagement were deceased, hospitalized, or ineligible for care. Of the remaining 68 Veterans, outreach efforts resulted in contact with 20, with 7 returning to care. Providers averaged 14.2 hours over 4 months conducting re-engagement services and reported that gaining facility leadership support and having service agreements for referrals were essential for program implementation. Conclusions. Population-level, panel management strategies to re-engage Veterans with mental disorders are potentially feasible if practices are identified to facilitate national rollout.
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Prescribing patterns of antidepressants, antipsychotics and mood stabilizers in bipolar patients misdiagnosed with major depressive disorder in China.
Hum Psychopharmacol
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Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to examine prescribing patterns of antidepressants, antipsychotics and mood stabilizers in BD patients misdiagnosed with MDD in China.
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Heterogeneity in aripiprazole diffusion for bipolar disorder treatment in the Veterans Health Administration.
Psychiatr Serv
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The objectives of this study were to ascertain the relative importance of scientific "approval" versus U.S. Food and Drug Administration (FDA) regulatory approval regarding changes in aripiprazole prescribing rates for treating bipolar disorder and to identify system-level covariates associated with faster regional uptake of aripiprazole.
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Posttraumatic stress disorder, depression, and health-related quality of life in patients with bipolar disorder: review and new data from a multi-site community clinic sample.
J Affect Disord
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Evidence suggests that patients with bipolar disorder have an elevated risk for comorbid posttraumatic stress disorder (PTSD) compared to those without a bipolar diagnosis. Although bipolar disorder is associated with decreased health-related quality of life (HRQOL), it is unclear whether comorbid PTSD interacts to affect HRQOL.
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Integrating bipolar disorder management in primary care.
Curr Psychiatry Rep
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There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care.
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Psychometric properties of the Chinese versions of the Quick Inventory of Depressive Symptomatology - Clinician Rating (C-QIDS-C) and Self-Report (C-QIDS-SR).
J Affect Disord
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Developing accurate and time-efficient tools to measure depressive symptoms is important for research and clinical practice. This study aimed to test the psychometric properties of the Chinese version of the 16-item Quick Inventory of Depressive Symptomatology - Clinician Rating (C-QIDS-C) and Self-Report (C-QIDS-SR).
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.