Abstract
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We assessed feasibility and acceptance of a specific MBC battery (Patient Health Questionnaire-9 item Depression Scale (PHQ-9; Kroenke et al. 2001), Generalized Anxiety Disorder 7-item Scale (GAD-7; Kroenke et al. 2001), Columbia Suicide Severity Rating Scale (C-SSRS; Posner et al. 2011), and Altman Self-Rated Mania Scale (ASRM; Altman et al. 1997) already used in adult clinics as part of the National Network of Depression Centers (NNDC). After IRB approval and receipt of appropriate consent/assent, surveys assessing attitudes about the MBC battery were completed by 52 clinicians from seven NNDC academic health centers and 74 adolescents being treated in those clinics. Responses from one site routinely utilizing this MBC battery (6 clinicians and 23 adolescents) were compared with those obtained from the other six sites.
We created a 23-item clinician survey based on an existing Feedback Questionnaire (Willis et al. 2009) and a 16-item adolescent survey to assess attitudes toward MBC. Total clinician scores ranged from 68 to 133 (102.1 ± 17.3), indicating an average of 4.4 (slightly agree to agree) for use of MBC. Mean item endorsements ranged from 3.0 ± 1.3 (slightly disagree) to 5.3 ± 1.0 (agree to strongly agree). Clinicians' qualitative comments were grouped into four themes: (1) the ASRM was not perceived to be useful, accurate, or reliable with adolescents; (2) measures should be reviewed for age-appropriate language; (3) additional training to interpret and use these measures was suggested; and (4) administration through tablets might facilitate patients completing measures and clinicians creating graphs and interpreting the measures, especially if outcomes could be integrated with clinics' established electronic health records.
Total adolescent scores ranged from 31 to 90 (70.5 ± 11.6), indicating an average of 4.4 (slightly agree to agree) for acceptance of MBC. Mean item endorsements ranged from 3.5 ± 1.6 (slightly disagree to slightly agree) to 5.0 ± 1.4 (agree) for the 16 items.
Scores were compared for six clinicians already using this battery to the other 46 clinicians. Experienced clinicians reported more favorable perceptions (115.3 ± 10.8) than inexperienced clinicians (100.4 ± 17.3), t(50) = 2.06, p = 0.045, d = 0.58.
Scores were compared for the 23 adolescents already completing this battery to the other 51 adolescents. Groups did not differ in their overall MBC endorsement (68.4 ± 14.8 vs. 71.5 ± 9.9, t(72) = 1.06, p = 0.291, d = 0.25).
This preliminary study suggests that MBC is generally feasible and accepted for use in adolescents with mood disorders. Additional study is needed to understand barriers to implementing MBC for youth and families seeking treatment for mood disorders.
Disclosures
Dr. Fristad receives research support from Janssen and the National Network of Depression Centers; royalties from American Psychiatric Publishing, Child & Family Psychological Services, Guilford Press, and JK Seminars.
Dr. Schneck receives research support from NIMH and the Ryan White Foundation.
Dr. Singh receives research support from NIH, Stanford's Maternal Child Health Research Institute and Department of Psychiatry, Johnson and Johnson, Allergan, PCori, and the Brain and Behavior Foundation. She is on the advisory board for Sunovion, X Moonshot Factory, and Skyland Trail, is a consultant for Google X and Limbix, and receives royalties from the American Psychiatric Association Publishing.
Dr. Weinstein and Dr. Ghaziuddin receives royalties from Oxford University Press.
Dr. Miller receives grant funding from Patient-Centered Outcomes Research Institute, Once Upon a Time Foundation, and the National Network of Depression Centers.
Drs. Bell, Dopp, Leffler, and Sullivan have no financial conflicts of interest to declare.