title: Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters.
abstract: OBJECTIVE
  The authors compared measurement-based care with standard treatment in major depression.
  
  
  METHODS
  Outpatients with moderate to severe major depression were consecutively randomized to 24 weeks of either measurement-based care (guideline- and rating scale-based decisions; N=61), or standard treatment (clinicians' choice decisions; N=59). Pharmacotherapy was restricted to paroxetine (20-60 mg/day) or mirtazapine (15-45 mg/day) in both groups. Depressive symptoms were measured with the Hamilton Depression Rating Scale (HAM-D) and the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). Time to response (a decrease of at least 50% in HAM-D score) and remission (a HAM-D score of 7 or less) were the primary endpoints. Outcomes were evaluated by raters blind to study protocol and treatment.
  
  
  RESULTS
  Significantly more patients in the measurement-based care group than in the standard treatment group achieved response (86.9% compared with 62.7%) and remission (73.8% compared with 28.8%). Similarly, time to response and remission were significantly shorter with measurement-based care (for response, 5.6 weeks compared with 11.6 weeks, and for remission, 10.2 weeks compared with 19.2 weeks). HAM-D scores decreased significantly in both groups, but the reduction was significantly larger for the measurement-based care group (-17.8 compared with -13.6). The measurement-based care group had significantly more treatment adjustments (44 compared with 23) and higher antidepressant dosages from week 2 to week 24. Rates of study discontinuation, adverse effects, and concomitant medications did not differ between groups.
  
  
  CONCLUSIONS
  The results demonstrate the feasibility and effectiveness of measurement-based care for outpatients with moderate to severe major depression, suggesting that this approach can be incorporated in the clinical care of patients with major depression.
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Tong
authors: T
authors: Guo
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Yu-Tao
authors: YT
authors: Xiang
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Le
authors: L
authors: Xiao
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Chang-Qing
authors: CQ
authors: Hu
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Helen F K
authors: HF
authors: Chiu
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Gabor S
authors: GS
authors: Ungvari
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Christoph U
authors: CU
authors: Correll
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Kelly Y C
authors: KY
authors: Lai
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Lei
authors: L
authors: Feng
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Ying
authors: Y
authors: Geng
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Yuan
authors: Y
authors: Feng
authors: From the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disorders, Beijing; the Unit of Psychiatry, Faculty of Health Sciences, University of Macau; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the University of Notre Dame Australia, Marian Centre, Perth; the School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth; and the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, N.Y.
authors: Gang
authors: G
authors: Wang
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000066491:Clinical Decision-Making; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D017374:Paroxetine / Q000627:therapeutic use*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D008803:Mianserin; D017374:Paroxetine; D000078785:Mirtazapine