Harmonized Outcome Measures for Use in Depression Patient Registries and Clinical Practice.

Major depressive disorder is a common mental health condition that affects an estimated 16.2 million adults and 3.1 million adolescents in the United States. Yet, a lack of uniformity remains in measurements and monitoring for depression both in clinical practice and in research settings. This project aimed to develop a minimum set of standardized outcome measures relevant to both patients and clinicians that can be collected in depression registries and clinical practice. Twenty-nine depression registries and related data collection efforts were identified and invited to submit outcome measures. Additional measures were identified through literature searches and reviews of quality measures. A multistakeholder panel representing clinicians; payers; government agencies; industry; and medical specialty, health care quality, and patient advocacy organizations categorized the 27 identified measures using the Agency for Healthcare Research and Quality's supported Outcome Measures Framework. The panel identified 10 broadly relevant measures and harmonized definitions for these measures through in-person and virtual meetings. The harmonized measures represent a minimum set of outcomes that are relevant to clinicians and patients and appropriate for use in depression research and clinical practice. Routine and consistent collection of these measures in registries and other systems would support creation of a national research infrastructure to efficiently address new questions, improve patient management and outcomes, and facilitate care coordination.

An Evaluation of the Effectiveness of Evidence-Based Psychotherapies for Depression to Reduce Suicidal Ideation among Male and Female Veterans.

BACKGROUND: Although most suicide-related deaths occur among male veterans, women veterans are dying by suicide in increasing numbers. Identifying and increasing access to effective treatments is imperative for Department of Veterans Affairs suicide prevention efforts. We examined the impact of evidence-based psychotherapies for depression on suicidal ideation and the role of gender and treatment type in patients' responses to treatment. METHODS: Clinicians receiving case consultation in interpersonal psychotherapy, cognitive-behavioral therapy for depression, and acceptance and commitment therapy for depression submitted data on depressive symptoms and suicidal ideation while treating veterans with depression. RESULTS: Suicidal ideation was reduced across time in all three treatments. A main effect for wave was associated with statistically significant decreases in severity of suicidal ideation, χ2 (2) = 224.01, p = .0001, and a subsequent test of the Gender × Wave interaction was associated with differentially larger decreases in ideation among women veterans, χ2 (2) = 9.26, p = .001. Within gender-stratified subsamples, a statistically significant Treatment × Time interaction was found for male veterans, χ2 (4) = 16.82, p = .002, with levels of ideation significantly decreased at waves 2 and 3 in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression; the Treatment × Wave interaction within the female subsample was not statistically significant, χ2 (4) = 3.41, p = .492. CONCLUSIONS: This analysis demonstrates the efficacy of each of the three tested evidence-based psychotherapies for depression as a means of decreasing suicidal ideation, especially in women veterans. For male veterans, decreases in suicidal ideation were significantly greater in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression.