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Mood Disorders

Randomised controlled trial of the clinical and cost effectiveness of a specialist mood disorders team for refractory unipolar depressive disorder

What we are doing:

Measuring the clinical and cost effectiveness of a collaborative care approach to the treatment of depression and comparing this to treatment in usual care.

Why we are doing it:

Mental disorder accounts for 40 per cent of all disability in Europe and 40 per cent of incapacity benefit claims in England. In 1990, unipolar depression was the fourth leading cause of “disability adjusted life years” in the world and by 2020 it is projected to be the second leading cause. The majority of suicides are associated with unipolar depression. Suicides in East Midlands have increased by one per cent in contrast to a national drop of six per cent (Anderson, 2006).

What the benefits will be:

Improved care for patients with a clinical diagnosis of moderate to severe depressive disorder in three local mental health services. We also aim to understand whether better implementation of standard care outlined by NICE guidelines for depression through enhanced specialist care providing pharmacotherapy and psychotherapy is required.

We are also exploring the barriers and drivers to the implementation of a collaborative approach to care, which will go on inform local commissioning services.

Who we are working with:

The study is now complete, and the findings are being written up. As a result of the study a tertiary Specialist Mood Disorder Service has been implemented within Nottingham City and consists of a psychiatrist and a psychotherapist working collaboratively to help patients in secondary care with moderate to severe depression.

The study involved the following organisations:

  • University of Nottingham
  • Nottingham Healthcare NHS Foundation Trust
  • Cambridgeshire & Peterborough NHS Foundation Trust
  • Derbyshire Healthcare NHS Foundation Trust
  • Lincolnshire Partnership NHS Foundation Trust
  • Nottingham County & City CCG
  • CLAHRC East of England
  • MRC Brain and Cognition Unit, University of Cambridge


Principal Investigator: Prof Richard Morriss 
Lead Researcher: Dr Catherine Kaylor-Hughes

Jayne Simpson

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