The integration of measurement and management for the treatment of bipolar disorder: a STEP-BD model of collaborative care in psychiatry.
Patients with bipolar disorder are among the most challenging to treat. These patients frequently present with complex mood and other symptoms that change over time, complex psychiatric and medical comorbid conditions, and multiple medications. Clinicians rarely systematically assess or measure all of these factors and instead rely on memory and general impressions. It is imperative that clinicians systematically track and monitor these relevant variables to ensure treatment decisions are based on precise clinical data. By integrating measurement and management, clinicians and patients can collaborate to assess the effectiveness of treatments and to make joint decisions about critical points at which to adjust treatment. This method was shown to be successful in the National Institute of Mental Health (NIMH) Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).
Nierenberg
Andrew A
AA
Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. ANierenberg@partners.org
Ostacher
Michael J
MJ
Borrelli
David J
DJ
Iosifescu
Dan V
DV
Perlis
Roy H
RH
Desrosiers
Astrid
A
Armistead
Molly S
MS
Calkins
Amanda W
AW
Sachs
Gary S
GS
D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D002985:Clinical Protocols; D015897:Comorbidity; D003299:Cooperative Behavior; D003625:Data Collection; D006801:Humans; D020407:Internet; D009315:National Institute of Mental Health (U.S.); D010346:Patient Care Management / Q000379:methods*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012107:Research Design; D016896:Treatment Outcome; D014481:United States