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Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project.

Publication ,  Conference
Trivedi, MH; Rush, AJ; Crismon, ML; Kashner, TM; Toprac, MG; Carmody, TJ; Key, T; Biggs, MM; Shores-Wilson, K; Witte, B; Suppes, T; Miller, AL ...
Published in: Arch Gen Psychiatry
July 2004

CONTEXT: The Texas Medication Algorithm Project is an evaluation of an algorithm-based disease management program for the treatment of the self-declared persistently and seriously mentally ill in the public mental health sector. OBJECTIVE: To present clinical outcomes for patients with major depressive disorder (MDD) during 12-month algorithm-guided treatment (ALGO) compared with treatment as usual (TAU). DESIGN: Effectiveness, intent-to-treat, prospective trial comparing patient outcomes in clinics offering ALGO with matched clinics offering TAU. SETTING: Four ALGO clinics, 6 TAU clinics, and 4 clinics that offer TAU to patients with MDD but provide ALGO for schizophrenia or bipolar disorder. Patients Male and female outpatients with a clinical diagnosis of MDD (psychotic or nonpsychotic) were divided into ALGO and TAU groups. The ALGO group included patients who required an antidepressant medication change or were starting antidepressant therapy. The TAU group initially met the same criteria, but because medication changes were made less frequently in the TAU group, patients were also recruited if their Brief Psychiatric Rating Scale total score was higher than the median for that clinic's routine quarterly evaluation of each patient. MAIN OUTCOME MEASURES: Primary outcomes included (1) symptoms measured by the 30-item Inventory of Depressive Symptomatology-Clinician-Rated scale (IDS-C(30)) and (2) function measured by the Mental Health Summary score of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) obtained every 3 months. A secondary outcome was the 30-item Inventory of Depressive Symptomatology-Self-Report scale (IDS-SR(30)). RESULTS: All patients improved during the study (P<.001), but ALGO patients had significantly greater symptom reduction on both the IDS-C(30) and IDS-SR(30) compared with TAU. ALGO was also associated with significantly greater improvement in the SF-12 mental health score (P =.046) than TAU. CONCLUSION: The ALGO intervention package during 1 year was superior to TAU for patients with MDD based on clinician-rated and self-reported symptoms and overall mental functioning.

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Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

July 2004

Volume

61

Issue

7

Start / End Page

669 / 680

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Texas
  • Surveys and Questionnaires
  • Severity of Illness Index
  • Psychotropic Drugs
  • Psychiatry
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
 

Citation

APA
Chicago
ICMJE
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Trivedi, M. H., Rush, A. J., Crismon, M. L., Kashner, T. M., Toprac, M. G., Carmody, T. J., … Shon, S. P. (2004). Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project. In Arch Gen Psychiatry (Vol. 61, pp. 669–680). United States. https://doi.org/10.1001/archpsyc.61.7.669
Trivedi, Madhukar H., A John Rush, M Lynn Crismon, T Michael Kashner, Marcia G. Toprac, Thomas J. Carmody, Tracie Key, et al. “Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project.” In Arch Gen Psychiatry, 61:669–80, 2004. https://doi.org/10.1001/archpsyc.61.7.669.
Trivedi MH, Rush AJ, Crismon ML, Kashner TM, Toprac MG, Carmody TJ, et al. Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project. In: Arch Gen Psychiatry. 2004. p. 669–80.
Trivedi, Madhukar H., et al. “Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project.Arch Gen Psychiatry, vol. 61, no. 7, 2004, pp. 669–80. Pubmed, doi:10.1001/archpsyc.61.7.669.
Trivedi MH, Rush AJ, Crismon ML, Kashner TM, Toprac MG, Carmody TJ, Key T, Biggs MM, Shores-Wilson K, Witte B, Suppes T, Miller AL, Altshuler KZ, Shon SP. Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project. Arch Gen Psychiatry. 2004. p. 669–680.

Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

July 2004

Volume

61

Issue

7

Start / End Page

669 / 680

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Texas
  • Surveys and Questionnaires
  • Severity of Illness Index
  • Psychotropic Drugs
  • Psychiatry
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs