Collaborative care for mood disorders.
OBJECTIVE
Psychiatric and health services research literature was reviewed to identify recent studies regarding effectiveness, cost-effectiveness, and generalizability of collaborative care programs to improve treatment of mood disorders.


RESULTS
Meta-analyses of previous randomized trials as well as recently conducted trials strongly support the effectiveness of collaborative care programs for depression across a broad range of primary care settings. Over time, the direct costs of providing more effective treatment for depression appear to be balanced by decreases in the use of general medical services, especially for patients with comorbid chronic medical illness. Given that the added costs of collaborative care are incurred early and economic benefits appear slowly, successful implementation of collaborative care programs will depend on adequate funding and availability of dedicated staff. Growing evidence supports the effectiveness of collaborative care programs to improve management of bipolar disorder in mental health specialty settings.


CONCLUSIONS
Given the strong evidence for the effectiveness, cost-effectiveness, and generalizability of collaborative care programs for depression in primary care, attention should turn to dissemination and implementation. Additional research is needed regarding effectiveness of collaborative care programs for more severe psychiatric disorders.
Simon
Gregory
G
Group Health Cooperative Center for Health Studies, Seattle, WA 98101, USA. simon.g@ghc.org
D001714:Bipolar Disorder / Q000628:therapy; D019090:Case Management / Q000191:economics; D003266:Continuity of Patient Care; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000628:therapy*; D006284:Health Plan Implementation; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D014481:United States