Pilot randomized trial of a cross-diagnosis collaborative care program for patients with mood disorders

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.

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.

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).

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