Precision Psychiatry Continuity Clinic Project

Study Overview
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Brief Summary
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This is a demonstration project focused on translating neuroscience insights into clinical practice. The researchers will evaluate how neuroscience assessments may be applied in the clinical setting to help inform care decisions. The aim of the study is to undertake a pragmatic pilot trial to assess whether the inclusion of structured feedback from neuroscience assessments has an effect on improving patient outcomes. The study will investigate how neuroscience assessments can be integrated into and improve clinical care. The impact of sharing information and conclusions from these assessments with psychiatric providers will be explored. Outcomes will include symptoms, social/occupational function and qualify of life.

Official Title
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Precision Psychiatry Continuity Clinic Project

Conditions
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Depressive Symptoms, Depressive Disorders, Anxiety Disorders and Symptoms, Psychological Distress, Mood Disorders

Intervention / Treatment
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* Other: Feedback Report


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18+ years of age Fluent and literate in English, and able to understand task instructions fMRI scanning eligibility, including no evidence of any form of metal embedded in the body (e.g., metal wires, nuts, bolts, screws, plates, sutures) Must be referred for treatment at the Stanford Department of Psychiatry Continuity Clinic Exclusion Criteria: Presence of suicidal ideations representing imminent risk General medical condition, disease or neurological disorder that interferes with the assessments Traumatic brain injury (history of physical brain injury or blow to the head resulting in loss of consciousness greater than five minutes) and which could interfere with doing the assessments Severe impediment to vision, hearing and/or hand movement, likely to interfere with ability to complete the assessments, or are unable and/or unlikely to follow the study protocols Pregnancy Presence of acute psychosis, schizophrenia spectrum, or other psychotic disorders Concurrent participation in intervention or treatment studies

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Feedback Group<br>All participants in the study will undergo a comprehensive neuroscience assessment including clinical questionnaires, a structured diagnostic interview, neuropsychological assessment, genetic testing, and structural and functional MRI. Participants randomized to the Feedback Group will have the results of this assessment shared with their psychiatric treatment team before they begin treatment. This data will be used at the full discretion of the treatment team to inform personalized treatment options. All treatment decisions remain up to the treatment providers and patient. | Other: Feedback Report<br>* A report of the data from the comprehensive neuroscience assessment is provided to the patient's care team.<br>|
| No Intervention: Delayed Feedback Group<br>All participants in the study will undergo a comprehensive neuroscience assessment including clinical questionnaires, a structured diagnostic interview, neuropsychological assessment, genetic testing, and structural and functional MRI. However, participants randomized to the Delayed Feedback Group will not have the results of this assessment shared with their treatment team until the end of their participation in this study (12 weeks). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Health Questionnaire (PHQ-9) | A 9-item questionnaire of self-reported symptoms of major depression commonly used in research and routine clinical care | 12 weeks | 
| Generalized Anxiety Disorder Questionnaire (GAD-7) | A 7-item questionnaire of self-reported symptoms of generalized anxiety commonly used in research and routine clinical care | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sheehan Disability Scale (SDS) of Social/Occupational Functioning | Level of functioning in social, occupational, and home life domains | 12 weeks | 
| Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER) | Burden of side effects from psychiatric medication | 12 weeks |