The Black Dog Institute Depression Clinic: a subtyping model in practice.
OBJECTIVE
The new Black Dog Institute Depression Clinic adopts a novel clinical service model that argues for the importance of clinically defining separate mood disorders in order to apply specific management strategies. This paper describes clinic nuances and the impact on diagnosis and management for the first 100 patients assessed.


METHODS
Patients are assessed via a computerized structured self-report program, a semistructured interview undertaken by a psychiatrist and a colloquium involving several practitioners where diagnostic decisions are formulated. A detailed report with treatment recommendations, incorporating psychiatric and psychological perspectives, is sent to the referring clinician. Such data are examined in this report.


RESULTS
We offered a differing diagnostic and treatment paradigm for nearly 90% of those diagnosed with a primary mood disorder. Difficulties encountered by referring practitioners are highlighted and the need for an alternative diagnostic and management model is discussed.


CONCLUSIONS
A subtyping diagnostic management model has the capacity to advance treatment outcome, but requires validation. Our future research will assess the comparative utility of the subtyping model in clinical and research arenas.
Parker
Gordon
G
School of Psychiatry, UNSW, Australia. g.parker@unsw.edu.au
Fletcher
Kathryn
K
Barrett
Melissa
M
Manicavasagar
Vijaya
V
D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001315:Australia; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D007406:Interview, Psychological; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*