Why "Measurement Makes a Difference" in Depression Care

Though measurement-based care is used by many primary care providers in treating illnesses like diabetes, it has been shown to be a powerful tool in the treatment of depression as well. At Psych Congress 2022, Greg Mattingly, MD, associate clinical professor at the Washington University School of Medicine discussed how clinicians can better utilize vital statistics and measurement-based care in his session "Not Getting Better!- Diagnostic Conundrums and Treatment Considerations in Mood Disorders." 

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Dr Mattingly previously touched on "vital statistics" here. 

Gregory Mattingly, MD, is a physician and principal investigator in clinical trials for Midwest Research Group. He is also a founding partner of St Charles Psychiatric Associates where he treats children, adolescents, and adults. A St Louis native, he earned his medical degree and received a Fulbright scholarship while attending Washington University. Dr Mattingly is board certified in adult and adolescent psychiatry and is a diplomat of the National Board of Medical Examiners. He is an associate clinical professor at Washington University where he teaches psychopharmacology courses for third-year medical students. Dr Mattingly has been a principal investigator in over 200 clinical trials focusing on ADHD, anxiety disorders, major depression, bipolar disorder, and schizophrenia. Having served on numerous national and international advisory panels, Dr Mattingly has received awards and distinctions for clinical leadership and neuroscience research. Dr Mattingly currently serves as the President-Elect for The American Professional Society of ADHD and Related Disorders and is a certified evaluator for the NFL regarding ADHD and head concussions. He also serves on the board of Headway House, a community support program for individuals with chronic mental illness. 

Read the Transcript:

I'm Dr Greg Mattingly, an associate clinical professor at the Washington University School of Medicine and president of the Midwest Research Group in St. Louis, Missouri.

So when you talk about using vital statistics, let's go back to our primary care analogy. You have your baseline physical exam, your once-yearly physical. I want to screen for everything right there. Because it's a screening visit, I want to make sure I'm not missing anything. But what happens if I'm treating diabetes? I want to sequentially measure your hemoglobin A1C. I want to measure any other comorbidities and see how you're doing. Something that we may not be used to, but there was a study done in a primary care setting that said, "What's the importance of measurement-based care, where I track your outcomes, versus just usual care?" And in this study, they looked at the importance of measurement-based care for managing cholesterol, managing type 2 diabetes, managing hypertension, and managing depression. Where did measuring symptoms make the biggest difference? It was treatment of depression. It was almost twice as important on the outcomes to your patients as the other, what we think of as common physical health conditions where we know measurement makes a difference.