One Year Pilot Study Comparing The Enhanced Common Mental Disorder Clinic And Conventional Specialist Outpatient Clinic In The Management Of Common Mental Disorders For Psychogeriatric Patients In Hong Kong

Abstract Description

Authors (including presenting author) :

Wong MMC (1), Pang PF(1), Yiu MGC(1)

Affiliation :

(1) Department of Psychiatry, United Christian Hospital

Introduction :

The enhanced Common Mental Disorder Clinic (CMDC) was developed by the Hospital Authority of Hong Kong with an aim to shorten new case waiting time at psychiatric specialist outpatient clinic (SOPC) for adult patients with common mental disorders (CMDs). It aims at providing early treatment in order to nip the problem in the bud. Each patient is under the care of a multi-disciplinary team.

Objectives :

This pilot study aims to find out the difference in drug treatment and need of follow up between patients attending psychogeriatric (PG) SOPC and CMDC and whether it is worthwhile to extend CMDC to PG patients.

Methodology :

30 consecutive patients were identified retrospectively from PG CMDC. Another 30 new cases with CMDs were identified from the PG SOPC consecutively for comparison of their clinical characteristics after one year of treatment.

Result & Outcome :

The waiting time for CMDC group (median of 89.5 days, IQR: 52.8) was significantly shorter than the SOPC group (mean: 425 days, SD: 220). After one year of treatment, there were significantly more patients who did not require medical follow up at 1-year for the CMDC group. Only fifteen (50%) patients remained in the CMDC while 23 remained in the SOPC. Ten (33.3%) patients completed the CMDC program and were successfully discharged from the CMDC. Psychiatrists of both clinics were able to reduce use of benzodiazepine/hypnotic. Half of the patients who were given benzodiazepine/hypnotics did not require it afterwards. Two thirds of them were treated with antidepressants after their first consultation. The rate of antidepressants use at 1-yr’s follow up was 11 (36.7%) for CMDC vs. 20 (69%) for SOPC patients. . CMDC had significantly reduced waiting time for doctor’s consultation by 80%. It was able to treat patients with CMDs so that there will be remission after 1-year of treatment. Its timely intervention may account for its success. It is worthwhile to extend the pro-gram to PG patients.