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The Integration of Measurement and Management for the Treatment of Bipolar Disorder: A STEP-BD Model of Collaborative Care in Psychiatry.

Andrew A. Nierenberg, MD; Michael J. Ostacher, MD, MPH; David J. Borrelli, MD; Dan V. Iosifescu, MD; Roy H. Perlis, MD; Astrid Desrosiers, MD; Molly S. Armistead, BA; Amanda W. Calkins, BA; and Gary S. Sachs, MD

Published: August 15, 2006

Article Abstract

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).

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