A. John Rush, MD, Discusses Patient-Driven Care for Mood Disorders


Thursday, Feb. 2 at 6pm, A. John Rush, M.D., gave a free lecture to the public at the Emerson Center for the Arts and Culture, titled “Patient-Driven Care: The Key to Recovery from Mood Disorders.” Rush is a professor emeritus at the Duke-NUS Graduate Medical School at the National University of Singapore and an adjunct professor of psychiatry and behavioral sciences at the Duke University School of Medicine. His research has focused on the testing of new treatments of depressive and bipolar disorders, such as medications, psychotherapy and other psychological fields. He has authored over 700 professional papers, books and book chapters and has received awards from quite a few organizations including the American College of Psychiatrists, the American Psychiatric Association and the Society for Biological Psychiatry, as well as many others.


Rush started off his talk by emphasizing his core belief: the patient and their families are the determinants of the success of a treatment. He believe that the treatment of mood disorders is not a matter of right or wrong; it’s a matter of tailoring and suiting. Knowing that plan A may not always work, Rush says it’s important to have a plan B, C and D ready to switch, combine and augment treatment to find what works best for each individual patient.


He then goes on to explain what exactly depression is, and how to tell if you or someone you know might be showing signs of it. First, he explained that there are different levels of depression and the difference between syndromes and a disease, cleverly comparing them to chest pains to show how serious each level is, i.e a bad reaction to spicy food is like being sad in reaction to a tragic event that occurred. Both hurt, but both pass fairly quickly.


Second, Rush listed some early indicators, including pain, fatigue, social withdrawal, apathy and insomnia. He also categorized symptoms of MDD (major depressive disorder) into two parts: mood (sleep, thinking and guilt) and interest (appetite/weight, energy and psychomotor changes). He emphasized was the concept of partnering up. When depressed, your mind can trick you into believing that your new way of thinking is the norm and therefore not unusual. By partnering up with a healthy friend or family member, you are capable of seeing where your thinking has gone awry.


Dr. Rush also took time to break down and explain four different forms used to screen and monitor mood disorders: the PHQ-9, QIDS-SR16, Sheen Disability Scale and the Mood Disorder Questionnaire (MDQ). The PHQ-9 is used to score the severity of the patient’s symptoms of depression, from 0 to 20. The QIDS-SR16 observes how the mood disorder has been affecting your daily functions, such as waking up on time, changes in appetite or general interests and energy levels. The Sheen Disability Scale measures how much the patient’s symptoms have affected their ability to perform in work/school, social and family life, and the MDQ is used to measure a patient’s potential symptoms of bipolar disorder. Copies of the first three tests are available online for anyone interested in measuring their own symptoms.


There was then a brief overview of current research in the field of depression, such as brain stimulation and ketamine injections. Rush wrapped up his talk by re-emphasizing the importance of “partner up”, and that the patient and their family are critical in making treatment work. He states that there is no one depression, and that it’s important to be patient in finding a treatment that works for someone, and to never, ever give up trying.

Written By Allie Hale