Clinical practice recommendations for depression (original) (raw)
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Psychiatria i Psychologia Kliniczna, 2018
The high prevalence of depression globally and the severe burden of this life-threatening mental illness necessitate an evidence-based approach to its treatment, in order to offer best-possible relief to those suffering from it. The present bestpractice guideline was originally developed by a team of psychiatrists, psychologists, and other mental health professionals at a large psychiatric teaching hospital and outpatient clinic network in Michigan, USA. The document draws from several current major guidelines for the treatment of adult patients with depressive disorders published by national and international health organisations, such as the American Psychiatric Association (USA), Canadian Network for Mood and Anxiety Treatments (Canada), National Institute for Health and Care Excellence (UK) and World Health Organization (EU). The present document emphasizes the areas of broad consensus across these guidelines and, as such, the treatment recommendations contained herein represent the current "gold standard" in the field of psychiatry in the West. Part I of this two-part series covers a range of relevant psychiatric treatment aspects, from general patient management to treatment-stagespecific and population-specific recommendations. Special attention is given to pharmacotherapy, somatic therapies, treatment strategies for non-response and management of perinatal depression. Additional resources, including clinicianand patient-oriented websites and links to the full-text major published guidelines, where available, are provided. Psychiatric clinicians are encouraged to utilise the evidence-based practice recommendations for best-possible patient outcomes.
Clinical practice guidelines for depression
Singapore medical journal, 2005
The Ministry of Health Clinical Practice Guidelines for Depression were prepared and distributed to all doctors in Singapore in early 2004. This article highlights salient points and discusses pharmacotherapy, psychotherapy and psychoeducation in managing cases of depression. Assessment of suicide risk is elaborated upon, although this was not discussed in the guidelines. The learning points will be enhanced if this article is reviewed together with the Ministry of Health Clinical Practice Guidelines.
Psychiatria i Psychologia Kliniczna, 2018
The high prevalence of depression globally and the severe burden of this life-threatening mental illness necessitate an evidence-based approach to its treatment, in order to offer best-possible relief to those suffering from it. The present bestpractice guideline was originally developed by a team of psychiatrists, psychologists, and other mental health professionals at a large psychiatric teaching hospital and outpatient clinic network in Michigan, USA. The document draws from several current major guidelines for the treatment of adult patients with depressive disorders published by national and international health organisations, such as the American Psychiatric Association (USA), Canadian Network for Mood and Anxiety Treatments (Canada), National Institute for Health and Care Excellence (UK) and World Health Organization (EU). The present document emphasizes the areas of broad consensus across these guidelines and, as such, the treatment recommendations contained herein represent the current "gold standard" in the field of psychiatry in the West. Part I of this two-part series covers a range of relevant psychiatric treatment aspects, from general patient management to treatment-stagespecific and population-specific recommendations. Special attention is given to pharmacotherapy, somatic therapies, treatment strategies for non-response and management of perinatal depression. Additional resources, including clinicianand patient-oriented websites and links to the full-text major published guidelines, where available, are provided. Psychiatric clinicians are encouraged to utilise the evidence-based practice recommendations for best-possible patient outcomes.
The management of depression: the evidence speaks for itself
The British Journal of Psychiatry
SummaryComparing the recommendations of two recently published national clinical practice guidelines for depression, this editorial highlights the concordance of advice concerning the selection and sequencing of therapies. Lifestyle and psychological interventions feature prominently and there is broad agreement regarding medication choice and optimisation strategies. The guidelines are therefore a useful resource.
BMC Psychiatry
Background: Clinical Practice Guidelines (CPGs) should follow an adequate methodology using an evidence-based approach in order to provide reliable recommendations. However, little is known regarding the quality of CPGs for Depression, which precludes its adequate use by stakeholders and mental health professionals. Thus, the aim of this study was to conduct a scoping review to describe the characteristics and quality of CPGs for Depression in adults. Methods: We searched CPGs for Depression in adults in eighteen databases. We included those that were published in English or Spanish between January 2014 and May 2018 and were based on systematic reviews of the evidence. Two independent authors extracted the characteristics, type and number of recommendations, and quality (using the Appraisal of Guidelines for Research and Evaluation-II [AGREE-II]) of each included CPG. Results: We included eleven CPGs, of which 9/11 did not include the participation of patients in the development of the CPG, 4/11 CPGs had a score ≥ 70% in the overall evaluation of AGREE-II, and 3/11 CPGs had a score ≥ 70% in its third domain (rigor of development). In addition, only 5/11 CPGs shared their search strategy, while only 4/11 listed the selected studies they used to reach recommendations, and 7/11 CPGs did not clearly state which methodology they used to translate evidence into a recommendation. Conclusions: Most of evaluated CPGs did not take into account the patient's viewpoints, achieved a low score in the rigor of development domain, and did not clearly state the process used to reach the recommendations. Stakeholders, CPCGs developers, and CPGs users should take this into account when choosing CPGs, and interpreting and putting into practice their issued recommendations.
Implementing practice guidelines for depression: Applying a new framework to an old problem
General Hospital Psychiatry, 2002
From time to time, the Journal receives manuscripts that can be thought of as opinion pieces, essays, or editorial comment on matters of topical interest. Such submissions will be refereed in the usual fashion and, if suitable, published in this section. The Editorial Board invites Letters to the Editor or rebutting commentary with the understanding that all submissions are subject to editing.
Development and implementation of guidelines for the management of depression: a systematic review
WOS, 2020
The quality and effectiveness of neurosurgical practices are under increased scrutiny as a result of economic pressures on the healthcare system and perceived variations in neurosurgical practice patterns nationally and internationally. Although it is intuitive that any neurosurgeon would seek to consistently apply the best available evidence to patient management, the actual application of evidence-based medicine (EBM) principles and clinical practice guidelines (CPGs) remains variable. In this article, we propose to review the origin and process of EBM as well as the development, assessment, and applicability of EBM and CPGs in neurosurgical care. In doing this, we hope to demonstrate that CPGs are one of the valid available options that exist to improve quality of care. Well-elaborated CPGs are useful tools to efficiently integrate current evidence and assist in the decision-making process while limiting variations in care to optimize patient outcomes without impeding neurosurgeons' autonomy and clinical judgment. CPGs are not intended to define the standard of care but rather to compile dynamic advisory statements, which need to be updated as new evidence emerges. Key Points 1) Clinical practice guidelines (CPGs), which involve a 1) systematic review, selection, and ranking of studies as evidence for each therapeutic option followed by 2) achievement of a multidisciplinary panel agreement based on the analysis of the strength of the latter evidence, offer a more reliable approach to achieving quality and effectiveness than expert opinion, which is principally derived from past experience. 2) CPGs are one of several tools available to improve health care delivery by assisting the decision-making process.
Journal of Psychopharmacology, 2000
A revision of the 2000 British Association for Psychopharmacology evidencebased guidelines for treating depressive disorders with antidepressants was undertaken to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in May 2006. Key areas in treating depression were reviewed, and the strength of evidence and clinical implications were considered. The guidelines were drawn up after extensive feedback from participants and interested parties. A literature review is provided, which identifies the quality of evidence to inform the recommendations, the strength of which are based on the level of evidence. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse, and stopping treatment.
Journal of Psychopharmacology, 2008
A revision of the 2000 British Association for Psychopharmacology evidencebased guidelines for treating depressive disorders with antidepressants was undertaken to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in May 2006. Key areas in treating depression were reviewed, and the strength of evidence and clinical implications were considered. The guidelines were drawn up after extensive feedback from participants and interested parties. A literature review is provided, which identifies the quality of evidence to inform the recommendations, the strength of which are based on the level of evidence. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse, and stopping treatment.