Nearly 4,000 psychiatric outpatients presenting for treatment in a hospital-affiliated, community-based, practice setting have been comprehensively evaluated with semi-structured diagnostic interviews including the Structured Clinical Interview (SCID) for Axis I disorders and Structured Interview for DSMV-IV Personality (SIDP) for Axis II disorders. Information on childhood trauma, family history of psychiatric disorders, psychosocial functioning, and demographic features has been obtained as well.
Current and future projects include:
Quality and Outcome of Treatment in the Partial Hospital Program
Recently, the MIDAS project has expanded to the partial hospital program at Rhode Island Hospital. Patients complete measures of depression, anxiety, and anger on a daily basis. An assessment of symptoms, quality of life, coping ability, overall sense of well-being, and psychosocial functioning is completed at admission and discharge. Patient satisfaction is assessed at intake and at the completion of treatment. Recent analyses have examined the predictors of premature drop-out. Future analyses will examine the speed and predictors of response.
Development of New Assessment Tools
A primary focus of this project is the development and investigation of newly constructed measures for clinician ratings of symptom severity/impairment and self-report questionnaires for patients. Projects have included validation of a questionnaire designed to assess DSM-IV major depressive disorder (Diagnostic Inventory for Depression, DID), and a questionnaire that screens for a broader compliment of DSM-IV diagnoses (the Psychiatric Diagnostic Screening Questionnaire, PDSQ). The studies of the PDSQ were funded by two National Institute of Mental Health (NIMH) grants.
Recently we have been awarded our second NIMH grant to develop a multidimensional scale that assesses both psychopathology and psychosocial function (the Multidimensional Assessment of Symptoms and Psychosocial Functioning, MASP). A goal of our scale development efforts has been the development of clinically useful scales for routine practice. Thus far we have developed and published the Clinically Useful Depression Outcome Scale (CUDOS), Clinically Useful Anxiety Outcome Scale (CUXOS), and Clinically Useful Social Anxiety Disorder Outcome Scale (CUSADOS). The CUDOS and CUXOS are included in a web-based system for measuring outcome. Most recently, the Remission from Depression Questionnaire (RDQ) has been developed from funding from NIMH and a pharmaceutical company. An expanded version of this scale, appropriate for all psychiatric patients, is currently under study.
Bariatric Surgery Program
We evaluate prospective surgical candidates with comprehensive semi-structured interviews for DSM-IV Axis I and Axis II disorders, as well as a supplemental interview module specifically focused on issues related to bariatric surgery. The initial goals of the program are to determine the percentage of patients who are not cleared for surgery due to psychiatric reasons and what those reasons are. During the past seven years more than 3,500 patients have been evaluated. Concurrently, we are planning the development of a screening questionnaire that could be used by the surgeons as a "first pass" screening test to determine which candidates need further psychiatric evaluation and which do not need a more extensive evaluation.