Major Depressive Disorder
Conditions
Keywords
Major Depressive Disorder, Telepsychiatry, Chinese American, Nursing Home
Brief summary
The current use of telepsychiatry, or psychiatric care using videoconferencing, is very limited. The present study investigates the use of this method with a depressed Chinese American population in a nursing home. It is believed that this population can benefit from telepsychiatric treatment when used in collaboration with the primary care they receive in the nursing home.
Detailed description
Individuals at the South Cove Manor nursing home will be referred to this study if they are experiencing depression. After meeting with the Principal Investigator (a psychiatrist), he will collaborate with the primary care physician and the nursing home staff to establish a treatment plan for the patient. Videoconferencing will be used by the P.I. for regular psychiatric visits with the patient as well as meetings with the nursing home staff to coordinate care for the patient. After collaboration between the two groups, treatment suggestions will be given to the patient's primary care physician (PCP) to implement in the primary care setting. The patient's symptomology, mood, satisfaction of life and side effects of medication will be recorded regularly to measure the effects of treatment for analysis.
Interventions
Antidepressant medication, prescribed at discretion of psychiatrist
BEHAVIORALCollaborative psychiatric and primary medical care
Regular care visits from health workers
Sponsors
Massachusetts General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of Major Depressive Disorder * Patient at South Cove Manor Nursing Home * Referred by nursing staff for psychiatric consultation
Exclusion criteria
* Not competent to participate in psychiatric interviews
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mean Scores on Clinical Global Impressions | Baseline, 30 days or 60 days (length depended on clinical needs of patients) | Minimum score - 1 (better outcome) Maximum score - 7 (worse outcome) |
| Patient/Family Telepsychiatry Service Satisfaction Survey | 30 days or 60 days (length depended on clinical needs of patients) | Patients' (or their family members' for those who had severe cognitive deficits) satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: not satisfied, satisfied, and highly satisfied. |
| Nurse Telepsychiatry Services Satisfaction Questionnaire | 30 days or 60 days (length depended on clinical needs of patients) | The charge nurse's satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: not satisfied, satisfied, and highly satisfied. |
Countries
United States
Participant flow
Recruitment details
The study was conducted from September 2006 to November 2007 as a collaborative project between Massachusetts General Hospital and South Cove Manor Nursing Home, which is located in Boston's Chinatown.
Participants by arm
| Arm | Count |
|---|---|
| Telepsychiatry Treatment Patients in the telepsychiatry treatment group will videoconference the P.I. for regular psychiatric visits in addition to meeting with nursing home staff. Treatment suggestions will be provided to the patient's primary care physician to be implemented. | 9 |
| Total | 9 |
Baseline characteristics
| Characteristic | Telepsychiatry Treatment |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 8 Participants |
| Age, Categorical Between 18 and 65 years | 1 Participants |
| Age Continuous | 77.33 years STANDARD_DEVIATION 11 |
| Region of Enrollment United States | 9 participants |
| Sex: Female, Male Female | 8 Participants |
| Sex: Female, Male Male | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 9 |
| serious Total, serious adverse events | 0 / 9 |
Outcome results
Primary
Change in Mean Scores on Clinical Global Impressions
Minimum score - 1 (better outcome) Maximum score - 7 (worse outcome)
Time frame: Baseline, 30 days or 60 days (length depended on clinical needs of patients)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Telepsychiatry | Change in Mean Scores on Clinical Global Impressions | -2.1 units on a scale | Standard Deviation 0.38 |
Primary
Nurse Telepsychiatry Services Satisfaction Questionnaire
The charge nurse's satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: not satisfied, satisfied, and highly satisfied.
Time frame: 30 days or 60 days (length depended on clinical needs of patients)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Telepsychiatry | Nurse Telepsychiatry Services Satisfaction Questionnaire | Highly Satisfied | 8 Participants |
| Telepsychiatry | Nurse Telepsychiatry Services Satisfaction Questionnaire | Satisfied | 1 Participants |
| Telepsychiatry | Nurse Telepsychiatry Services Satisfaction Questionnaire | Not Satisfied | 0 Participants |
Primary
Patient/Family Telepsychiatry Service Satisfaction Survey
Patients' (or their family members' for those who had severe cognitive deficits) satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: not satisfied, satisfied, and highly satisfied.
Time frame: 30 days or 60 days (length depended on clinical needs of patients)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Telepsychiatry | Patient/Family Telepsychiatry Service Satisfaction Survey | Highly not satisfied | 0 participants |
| Telepsychiatry | Patient/Family Telepsychiatry Service Satisfaction Survey | Not satisfied | 0 participants |
| Telepsychiatry | Patient/Family Telepsychiatry Service Satisfaction Survey | Satisfied | 1 participants |
| Telepsychiatry | Patient/Family Telepsychiatry Service Satisfaction Survey | Highly satisfied | 7 participants |
| Telepsychiatry | Patient/Family Telepsychiatry Service Satisfaction Survey | No response | 1 participants |