MOC PIP Clinical Module #1
Assessing and Monitoring Fatigue in Depression

This clinical module is designed to help psychiatrists meet the American Board of Psychiatry and Neurology (ABPN) Part 4 performance in practice (PIP) requirement for Maintenance of Certification (MOC).

The module focuses on assessing and monitoring fatigue in depression. Several studies have shown that people with fatigue are at an increased risk for development of major depression; however research shows that fatigue is only identified and treated in a relatively small proportion of those affected. The importance of clinicians' ability to define and recognize fatigue is underscored by the fact that patients are unlikely to self-report. Ideal treatment of patients with fatigue and depression requires expertise with complex pharmacologic treatment strategies. Fatigue can also be a side effect of antidepressant treatment, and failure to recognize side effects can result in prolonged morbidity as well as medication non-adherence. However, physicians largely underestimate the rate of side effects, such as fatigue, when compared to the rate reported by their patients.

What is MOC PIP?

Performance in practice (PIP) activities are required as part of ABPN Maintenance of Certification (MOC) requirements. PIP is a quality improvement activity for physicians to assess their current practice patterns, compare those practice patterns to a set of best-practices, participate in educational activities to improve their practice, and then re-evaluate their practice following the educational interventions.

How this module works

The entire activity takes 12-24 months to complete and consists of three stages.

Stage A _ Initial Assessment
Collect and enter data from 5 of your patients with a primary diagnosis of major depression. Receive feedback regarding your performance in evaluating and treating these patients.

Stage B _ Educational Interventions
Education includes an interactive learning module and an online simulation, as well links to published papers, rating scales and other resources that you can use with your patients. Complete recommended educational interventions within 3 months of completing Stage A.

Stage C _ Follow-Up Assessment
Collect and enter data from 5 of your patients with a primary diagnosis of major depression. These patients must have been evaluated after completion of Stage B. Receive feedback regarding your performance in evaluating and treating these patients. Complete this stage within 24 months of completing stage B.

Your participation in this activity will be reported to the ABPN within 6 weeks of completion. Your individual answers will not be reported to the Board.

Click here to view a complete program overview.

Target Audience

This program is intended for: Psychiatrists looking to meet ABPN MOC-4 PIP requirements.


The cost of this module is: $35.00

Cancellation Policy

Refunds will be issued for requests received within 5 business days of purchase, but an administrative fee of $10.00 will be deducted from your refund. No refunds will be made thereafter. Additionally, no refunds will be made for individuals who claim credit, regardless of when they request a refund.


  • Director, Division of Education
    Deputy Medical Director
    American Psychiatric Association
    Assistant Professor of Psychiatry, Harvard Medical School
    Consultant, Department of Psychiatry, Massachusetts General Hospital
  • Medical Editing & Knowledge Management
    Postgraduate Medical Education
    Massachusetts General Hospital
    Instructor in Psychiatry, Harvard Medical School
  • Director, Depression Clinical and Research Program
    Massachusetts General Hospital

    Associate Professor of Psychiatry
    Harvard Medical School

More Information on Maintenance of Certification

We offer courses to help you with every stage of the Maintenance of Certification process.
Learn more about the MOC process and see the full list of courses.

CE Information

Release Date:May 19, 2014
Review Date: April 30, 2020
Expiration Date:April 30, 2021

To receive credit for this activity, complete the module, complete the evaluation, and enter the required information.

Accreditation Statement

This program is not accredited.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education. CME credit is not being offered for this activity.

Credit Designation

Even though this event is not accredited, providing information regarding planning, disclosure, and conflict of interest is important to us. Some providers may be able to claim Category 2 CME credit for participating in this activity.

Faculty Disclosure Statement

In accord with the guidelines of the Accreditation Council for Continuing Medical Education (ACCME), planners, speakers and anyone who may have an influence on the content of the activity have been asked to disclose any relationship they or their spouse/partner have to companies producing pharmaceuticals, medical equipment, devices, etc. that may be germane to the content of their presentation. Such disclosure is not intended to suggest or condone bias, but provides participants with information that might be of potential importance to their evaluation of a given presentation.

Resolution of Conflict of Interest (COI)

The MGH Psychiatry Academy has implemented a process to resolve potential COIs for this CME activity to help ensure content objectivity, independence, fair balance and ensure that the content is aligned with the interest of the public.

Planner Disclosures

The following planners and/or their spouse/partner have reported no relevant financial relationship with a commercial interest.

Tristan Gorrindo, MD

The following planners and/or their spouse/partner have reported a relevant financial relationship with a commercial interest.

Michael Hirsch, MD
Honoraria for writing: UpToDate

Speaker Disclosures

The following speakers and/or their spouse/partner have reported a relevant financial relationship with a commercial interest.

David Mischoulon, MD, PhD
Research support: TheBowman Family Foundation, Bristol-Myers Squibb Co., Cederroth, FisherWallace, Ganeden, Lichtwer Pharma, Nordic Naturals, Laxdale (Amarin), Methylation Sciences, Inc. (MSI), SwissMedica
Honoraria for consulting, speaking, and writing:Pamlab, Bristol-Myers Squibb Co., Nordic Naturals, Virbac, Pfizer, Reed Medical Education, Massachusetts General Hospital Psychiatry Academy
Royalties:Back Bay Scientific for PMS Escape, Lippincott Williams & Wilkins for published book "Natural Medications for Psychiatric Disorders: Considering the Alternatives"

Hardware/Software Specifications

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration
Flash Player: Adobe Flash Player 10.1+ Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
Operating System: Windows XP+ or Mac OS X 10.4+ Internet Connection: 1 Mbps or higher

Minimum Requirements

Windows PC: 500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit

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