Implementing composite quality metrics for bipolar disorder: towards a more comprehensive approach to quality measurement.

Objective: 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.

Method: Data from medical record reviews were used to assess key processes of care for 433 VA mental health outpatients with bipolar disorder. Both composite and individual processes of care measures were operationalized.

Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

Objectives: 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.

Predictors of adequate depression treatment among Medicaid-enrolled adults.

Objective: To determine whether Medicaid-enrolled depressed adults receive adequate treatment for depression and to identify the characteristics of those receiving inadequate treatment.

Data Source: Claims data from a Medicaid-enrolled population in a large mid-Atlantic state between July 2006 and January 2008.

Study Design: We examined rates and predictors of minimally adequate psychotherapy and pharmacotherapy among adults with a new depression treatment episode during the study period (N=1,098).

Effect of depression treatment on chronic pain outcomes.

Objective: To examine the effect of depression treatment on medical and social outcomes for individuals with chronic pain and depression. People with chronic pain and depression have worse health outcomes than those with chronic pain alone. Little is known about the effectiveness of depression treatment for this population.

Pain interference impacts response to treatment for anxiety disorders.

Background: Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety.

Methods: This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N=191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12-month course of telephone-based collaborative care.

Quality of depression care for people with coincident chronic medical conditions.

Objective: Depression is common and associated with poor outcomes for people with chronic medical conditions (CMCs). The goals of this study were (1) to determine the effect of CMCs on the use and quality of depression care and (2) to understand whether the patient-provider relationship mediates the relationship between CMCs and depression care quality.

Method: With the use of data from the 1997-1998 National Survey of Alcohol, Drug, and Mental Health Problems (Healthcare for Communities), the relationships between CMCs, depression recognition, receipt of minimally adequate depression care and the patient-provider relationship were assessed with multivariate linear and logistic regression models for 1309 adults who met criteria for major depressive disorder.

Gender differences in health-related quality of life for veterans with serious mental illness.

Objective: This study assessed gender differences in health-related quality of life (HRQOL) in a national sample of veterans with serious mental illness.

Methods: Data were analyzed from the Large Health Survey of Veterans, which was mailed to a national random sample of veterans in 1999. The linear and logistic multiple regression analyses included 18,017 veterans with schizophrenia, schizoaffective disorder, or bipolar disorder who completed the survey.