Neuropsychiatric disorders such as schizophrenia, bipolar disorder, and major depressive disorder are serious, debilitating, and clinically complex disorders that often pose a considerable challenge to clinicians. While practice guidelines may assist clinicians in management, clinical trial data is often rapidly emerging to identify evidence-based strategies to optimize clinical management.

Given the significant clinical and quality of life impact of neuropsychiatric disorders, the identification and implementation of safe, effective management strategies is paramount. The CME Outfitters, LLC Neuroscience Hub is designed to provide clinicians with the latest clinical practice guidelines, diagnostic strategies and tools, and scientific updates on current and emerging therapies to optimize management of neuropsychiatric disorders.

CME/CE Activities

Long-Acting Injectables: An Effective, Yet Often Underutilized Tool for Rapid Symptom Reduction and Restoration of Function

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Schizophrenia is a serious and debilitating disorder that often poses a considerable challenge to clinicians. While long-acting injectables (LAIs) have emerged as a viable means to address patient nonadherence – often a component of schizophrenia management – clinicians often fail to implement the use of LAIs. Many times this is due to clinicians not being aware of updates such as the introduction of LAIs with increased dosing intervals, knowledge that is an important aspect of narrowing practice gaps in the treatment of this clinically complex disorder. For the first episode in this three-part CMEOcast podcast series on schizophrenia, expert faculty translate the latest data on the impact of LAIs vs. oral therapies in relapse prevention and rapid symptom reduction.

Current and Emerging Therapies for Schizophrenia: How MOA Affects Clinical Outcomes

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Clinical trial data that addresses the safety and efficacy of antipsychotics is continuously emerging, with a focus on optimizing the management of schizophrenia. These data include the identification of strategies with novel mechanisms of action (MOAs) to effectively resolve symptoms and promote recovery while minimizing metabolic effects. The second episode of this schizophrenia CMEOcast podcast series explores the MOAs of current and emerging therapies for schizophrenia. Expert faculty feature pertinent information on differentiating these MOAs as well as their influence on clinical outcomes, and learners have the option of an audio-only version of the episode or to view it with the additional resource of a faculty-guided tour of an animated 3-D model.

Recent Clinical Trial Data on the Safety and Efficacy of Current and Emerging Therapies to Optimize Schizophrenia Management

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Safe and effective treatments for schizophrenia are imperative to optimizing personalized therapy, which helps in reducing relapse and promoting functional recovery in patients with schizophrenia. Emerging data on reducing symptoms, maintaining effective therapy over long-term periods, and minimizing treatment-related metabolic side effects can guide clinicians in choosing the best therapies for their patients. In the final episode of the CMEOcast podcast series on schizophrenia, expert faculty focus on the utilization of this data in clinical practice in order to assist clinicians in optimizing their management of schizophrenia.

Routine Screening for Depression Like We Screen for Hypertension

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Depression is a common, debilitating disorder affecting 12.8% of adolescents and 6.7% of adults in the United States. Routine depression screening is critical to ensure opportunities are not missed to provide patient treatment. The role of primary care in screening, detection, and treatment of depression has grown, becoming the point-of-care where most people seek treatment. A recent study of five health care systems was published representing data from 241,251 adults newly diagnosed with depression in primary care settings. Efforts to improve depression outcomes in primary care have focused on improved screening, but in the study population, only 11% of patients had a PHQ-9 score measured and recorded on the index date of diagnosis, demonstrating a significant gap in the utilization of screening tools. In part one of this free CME Outfitters Snack series, expert faculty present an engaging, focused video discussion using the ArchViewer platform to discuss improved screening and use of measurement-based care in patients with depression.

Moving Beyond “Better” to Getting Patients “Well”: Tools to Measure How “Well” Your Patient is Doing with Treatment

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Primary care has become the point-of-care where most people seek treatment for depression, and effort to improve depression outcomes in primary care have focused on improved screening and implementation of collaborative and measurement-based care. However, a recent study showed that only 35.7% of patients diagnosed with depression had treatment initiated, despite the demonstrated value of consistently monitoring and measuring symptomatology and daily functioning of patients with depression. Measurement-based care strategies are essential to provide the best chance for successful treatment and sustained remission. In part 2 of this free CME Outfitters Snack series, expert faculty present an engaging, focused video discussion using the ArchViewer platform to discuss a measured approach to screening and treating depression including the feasibility, necessity, and effectiveness of these practices to enhance patient care.

From Bench to Bedside: Novel Strategies Addressing the Negative Symptoms of Schizophrenia to Improve Clinical and Functional Outcomes

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Schizophrenia is a chronic and debilitating disease, and pharmacotherapy for it has focused on the management of positive symptoms using atypical antipsychotics, leading to negative symptoms that contributed more to impaired quality of life being left untreated or underrated. Due to the persistent and chronic nature of negative symptoms, the need for effective therapy with a novel mechanism of action (MOA) is paramount. This CME Outfitters Snack features expert faculty examining the impact on negative symptoms in remission and recovery, evaluating clinical trial updates on novel therapies with unique MOAs, and integrating pharmacologic knowledge of D3 receptor function as it pertains to treatment selection for the negative symptoms of schizophrenia.

Moving the Needle in Bipolar I Depression: Novel Strategies to Improve Patient Outcomes

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Bipolar I depression is a serious, debilitating disorder, and the challenge of management is compounded by the limited treatment options that are available. Current D2-targeted strategies to manage bipolar depression are limited in their effectiveness, as these approaches do not specifically target the neurobiology of the disease. Data is emerging that demonstrates that the novel treatment strategies that target D2 receptors have shown significant clinical benefit in reducing symptom burden and improving quality of life in patients with bipolar I depression. This CME Outfitters Snack features a faculty-guided interactive 3-D model animation that examines how D2 receptors relate to the pathogenesis of the bipolar I depression, and subsequently, how D2-targeted therapies exert their beneficial effects in promoting symptomatic remission and functional recovery.
Resource Links
Practice Guidelines

Keepers GA, et al. The American Psychiatric Association Practice Guideline for the Treatment of patients with Schizophrenia. [to be released summer 2020]

Hirschfeld RMA et al. Practice Guideline for the Treatment of Patients with Bipolar Disorder. Second Edition.

Gelenberg AJ, et al. Practice Guideline for the Treatment of Patients with Major Depressive Disorder.

Inventories
Mood Disorder Questionnaire (MDQ) The Mood Disorder Questionnaire (MDQ) can be administered either by the clinician or self-administered by the patient. The MDQ consists of 15 questions and takes about 5 minutes to complete.

Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16) Quick Inventory of Depressive Symptomatology (Self-Report) (QIDS-SR-16) has proven useful for many years as a way of determining a patient’s level of depression before, during, and after treatment.

Bipolar Spectrum Diagnostic Scale (BSDS) The Bipolar Spectrum Diagnostic Scale (BSDS) is a descriptive story that captures subtle features of bipolar illness.

Beck Depression Inventory-II (BDI-II) The Beck Depression Inventory-II (BDI-II): 1996 revision of the BDI 21-item self-report multiple-choice inventory ~ 10 minutes to complete. Widely used indicator of the severity of depression.

Patient Health Questionnaire (PHQ-2) Use the Patient Health Questionnaire (PHQ-2) to screen for depression.

Edinburgh Postnatal Depression Scale (EPDS) Proven to be an effective screening tool to identify patients at risk for “perinatal” depression. Mother asked to check the response that comes closest to how she has been feeling in the previous 7 days.

Geriatric Depression Scale Short Form (GDS-SF) 15-item screening tool used to identify depression in older adults

Hamilton Depression Rating Scale (HAM-D) The Hamilton Depression Rating Scale (HAM-D) has proven useful for many years as a way of determining a patient’s level of depression before, during, and after treatment.

Brief Psychiatric Rating Scale (BPRS) Comprehensive 24-item symptom scale

Medication Adherence Rating Scale (MARS) The total score ranges from 0-10 with a higher score indicating better adherence

Brief Adherence Rating Scale (BARS)