EpxDepression

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Intervention Details

Summary

EpxDepression tracks patients’ mood (up to 3 times a week) and depressive symptoms via the PHQ-9 (up to twice a month).

Indications

Patients diagnosed with or at risk for major depressive disorder.

Intervention

Mood is evaluated three times a week. The PHQ9 is administered over the course of three days twice monthly. Question frequency is adjusted depending on the patient’s needs. A mood of 0 to 1 triggers a question about suicidality. A “yes” response to this question, or to question 9 of the PHQ-9, alerts the provider and redirects the patient to a crisis call center. A mood of 2 to 3 triggers a text that asks whether the patient would like to speak to a caring crisis volunteer.

Communication Modes

Every 2 Days or weekly

Messages

Mood (daily, various phrasing)

What is your mood now? Please respond on a scale from 0 (very bad) to 10 (very good)

PHQ9 (monthly)

Over the past 2 weeks, have you had little interest or pleasure in doing things? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you felt down, depressed, or hopeless? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you had trouble sleeping or slept too much? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you felt tired or had little energy? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you had poor appetite or eaten too much? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you felt like a failure? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you had trouble concentrating? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, have others noticed you moving or speaking slowly? Being fidgety or restless? Rate from 0 (not at all) to 3 (almost daily)
Over the past 2 weeks, how often have you thought you would be better off dead or of hurting yourself? Rate from 0 (not at all) to 3 (almost daily)

Alerts

The provider is alerted if the patient responded with 1 or more for question 9. The patient will immediately be given the option to call a 24/7 crisis hotline.

Emergencies

Patients will be directed to call 911 if they are experiencing an emergency. You may designate a care provider to be acutely notified in the event of a defined critical value.

Intervention Team

Principal Investigators

Anne Glowinski MD

Psychiatrist
Professor

Washington University School of Medicine

Brianne Newman MD

Assistant Professor of Psychiatry

Washington University School of Medicine
Center for Outpatient Health Psychiatric Clinic

Clinical Team

Nan Zhao

Medical Student (MD) '19

Saint Louis University School of Medicine

Robert Chen

Medical Scientist Training Program (MD/PhD) '22

Washington University School of Medicine in St. Louis

Avik Som

Medical Scientist Training Program (MD/PhD) '18