Seven-day shared decision making for outpatients with first episode of mood disorders among university students: A randomized controlled trial

Yumi Aoki; Yoshikazu Takaesu; Masato Inoue; Takehiko Furuno; Yasushi Kobayashi; Hiromi Chiba; Yasuhide Kakita; Masashi Hori; Hisateru Tachimori; Koichiro Watanabe

doi:10.1016/j.psychres.2019.112531

Seven-day shared decision making for outpatients with first episode of mood disorders among university students: A randomized controlled trial

Psychiatry Res. 2019 Nov:281:112531. doi: 10.1016/j.psychres.2019.112531. Epub 2019 Aug 30.

Authors

Affiliations

¹ Psychiatric and Mental Health Nursing, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan. Electronic address: [email protected].
² Department of Neuropsychiatry, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
³ Science and Engineering, Waseda University, 3-4-1 Ookubo, Shinjuku-ku, Tokyo 169-8555, Japan.
⁴ Department of Psychiatry, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
⁵ Department of Health Care Center, The Dai-ichi Life Insurance Company Limited, 1-13-1 Yurakucho, Chiyoda-ku, Tokyo 100-8411, Japan.
⁶ Department of Psychiatry, Jiundo Hospital, 4-14-53 Sekimachi Minami, Nerima-ku, Tokyo 177-0053, Japan.
⁷ Department of Psychiatry, Henmi Hospital, 3-26-16 Hagiyama-cho, Higashimurayama-shi, Tokyo 189-0012, Japan.
⁸ School of Education, Waseda University, 1-104 Totsukamachi, Shinjuku-ku, Tokyo 169-8050, Japan.
⁹ Department of Mental Health Policy and Evaluation, National Institute of Mental Health, NCNP, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo 187-0031, Japan.
¹⁰ Department of Neuropsychiatry, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan. Electronic address: [email protected].

PMID: 31521046
DOI: 10.1016/j.psychres.2019.112531

Abstract

Providing appropriate treatment to patients with a first episode of mood disorders is crucial for recovery from the disorders. Although shared decision making (SDM) has been proposed as a promising model in psychiatric practice, an appropriate SDM approach has not yet been established. The aim of the current study was to evaluate the effects of an originally developed seven-day SDM program for outpatients with a first episode of mood disorders among university students. University students with a first episode of mood disorders were randomly allocated into two arms: SDM and control. The participants in the SDM arm received the seven-day SDM program, which included option presentation consultation, external deliberation with a decision aid booklet, decision coaching by a nurse, and decision-making consultation. The control arm received usual care. The primary outcome was patient-perceived involvement. We enrolled 88 participants. Compared with usual care, the SDM program significantly improved patient-perceived involvement in treatment decision making without taking up clinicians' time. The program did not lead to worse symptoms of mood disorders. In conclusion, sharing treatment decision making with university students with a first episode of mood disorders is feasible.

Keywords: Bipolar disorders; Decision aid; Decision making; Decision support techniques; Depression; Patient participation; SDM; Young adult.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Decision Making, Shared*
Feasibility Studies
Female
Humans
Male
Mood Disorders / psychology
Mood Disorders / therapy*
Outpatients / psychology*
Patient Participation / methods*
Patient Participation / psychology
Program Evaluation
Referral and Consultation
Students / psychology*
Universities
Young Adult