Psychiatrists and mental health professionals now have an updated set of clinical guidelines for managing major depression. The Canadian Network for Mood and Anxiety Treatments (CANMAT) published the refreshed guidelines, which are the most widely used in the world for depression. This new version incorporates the latest scientific evidence and advancements in depression care since the previous guidelines were released.Published in 2016, the revision of the recommendations was spearheaded by a team of researchers from the University of B.C. and the University of Toronto, in collaboration with a national working group consisting of over 40 academic clinical experts and patient partners.
Co-lead author Dr. Raymond Lam, who is a professor of psychiatry at UBC and co-director of the Mood Disorders Centre at the Djavad Mowafaghian Centre for Brain Health, stated, “These recommendations not only represent the evidence and broad consensus of leading experts in depression research and care, but, importantly, they also reflect the perspectives of patients with lived experience. Our hope is that this update will empower clinicians with tThe most recent recommendations aim to improve the outcomes and quality of life for the many individuals dealing with depression. More than 10% of Canadians will experience depression at some point, making it a significant public health issue. However, only about 20% of people receive the treatment they need.
The new guidelines address eight key areas that cover the entire patient care journey, from assessment and diagnosis to selecting treatments and preventing recurrence. The format of question-and-answer is meant to be practical and easy to use.The guidelines have been updated to make them more user-friendly for clinicians. The working group reviewed new scientific evidence and took into account feedback from patients and experts to create the revised guidelines. The recommendations are organized based on the level of evidence supporting each therapy, as well as factors such as safety and feasibility. Healthcare professionals are provided with guidance to help them choose the most suitable treatment option, with a focus on collaboration.decision-making.
According to Dr. Lam, depression is a complex and personalized condition. The guidelines emphasize the significance of working with patients to make care decisions and offering a tailored treatment approach that takes into account a person’s needs, preferences, and treatment history.”
The guidelines emphasize the strong evidence supporting established first-line treatments, such as various medications, and psychological treatments like cognitive behavioural therapy, interpersonal therapy, and behavioral activation. Recent evidence also supports the use of several medications in treating depression, providing healthcare professionals with additional options for personalized care.
If the list of treatment options were expanded to include new psychological and pharmacological treatments.
According to co-lead author Dr. Sidney Kennedy, the new guidelines place a strong emphasis on patient involvement in treatment selection, the use of outcome measures throughout care, and an overview of digital mental health tools for managing depression. Dr. Kennedy is a professor of psychiatry at the University of Toronto and director of the Centre for Depression and Suicide Studies at Unity Health Toronto.
The guidelines also provide additional guidance on how healthcare professionals can integrate lifestyle interventions, such as exercise.
Exercise, diet, and sleep habits are all important factors in treating depression. The article also discusses the timing for considering neuromodulation treatments and what to do if a patient doesn’t respond to initial treatments or develops treatment-resistant depression.
Dr. Lena Quilty, co-author of the article, and associate professor of psychiatry at the University of Toronto, as well as a senior scientist at the Centre for Addiction and Mental Health, emphasizes the growing support for the effectiveness of established psychological and behavioral interventions in various delivery formats. The article also highlights new interventions targeting depression.CANMAT is a group of experts in academic and clinical fields who are committed to enhancing clinical care for individuals with mood and anxiety disorders. The latest guidelines for depression have been released in The Canadian Journal of Psychiatry. Updated versions of the CANMAT Pocket Guide to Depression for clinicians and the CHOICE-D Patient and Family Guide to Depression Treatment will also be made available by the researchers. These guidelines aim to address the complexities of depression and its commonly co-occurring challenges such as anxiety or disrupted cognitive processes, with the hope of providing more comprehensive attention to these multifaceted issues.
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