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New guidelines for depression care emphasize patient-centered approach
in Canada
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Principles of clinical assessment and management of major depressive
disorder. Credit: _The Canadian Journal of Psychiatry_ (2024). DOI:
10.1177/07067437241245384
Psychiatrists and mental health professionals have a new standard for
managing major depression, thanks to refreshed clinical guidelines
published today by the Canadian Network for Mood and Anxiety
Treatments (CANMAT).
The CANMAT guidelines are the most widely used clinical guidelines for
depression in the world. The new version integrates the latest
scientific evidence and advances in depression care since the previous
guidelines were published in 2016. The update was led by researchers
at the University of B.C. and the University of Toronto, alongside a
national working group of more than 40 academic clinical experts and
patient partners.
"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," says co-lead author Dr. Raymond Lam, professor of
psychiatry at UBC and co-director of the Mood Disorders Centre at the
Djavad Mowafaghian Centre for Brain Health.
"Our hope is that this update will empower clinicians with the latest
recommendations that can help achieve better outcomes and improved
quality of life for the millions of people affected by depression."
More than one in 10 Canadians will experience depression at some point
in their lives, making it one of the largest public health burdens in
Canada. However, it is estimated that only 20% of people receive
adequate treatment.
The updated guidelines cover eight primary topic areas that map the
patient care journey, from assessment and diagnosis through to the
selection of treatments and strategies to prevent recurrence. The
question-and-answer format is designed to be practical, accessible and
easy for clinicians to use.
To develop the refreshed guidelines, the working group conducted a
comprehensive literature review of new scientific evidence published
since the previous 2016 guidelines. Drafts were revised based on
review by patient partners, expert peer review and a defined expert
consensus process.
The resulting recommendations are organized by lines of treatment
based on the level of evidence supporting each therapy and factors
such as safety, tolerability and feasibility. Guidance is provided to
aid health care professionals in choosing the right treatment option
with an emphasis on collaborative decision-making.
"Depression is a complex and highly individualized condition," says
Dr. Lam. "The guidelines highlight the importance of collaborating
with patients in care decisions and providing a personalized treatment
approach that carefully considers a person's needs, preferences and
treatment history."
The guidelines underline the strong evidence base for well-established
first-line treatments, including a number of medications, as well as
psychological treatments such as cognitive behavioral therapy,
interpersonal therapy and behavioral activation. Based on recent
evidence, a number of new psychological and pharmacological treatments
were added to the list of treatment options.
"Notable additions to the new guidelines are a strong emphasis on
patient participation in choosing treatment, applying outcome measures
throughout care, and an overview of digital mental health tools in the
management of depression," says co-lead author Dr. Sidney Kennedy,
professor of psychiatry at the University of Toronto and director of
the Centre for Depression and Suicide Studies at Unity Health Toronto.
The guidelines include further direction on how health care
professionals can incorporate lifestyle interventions, such as
exercise, nutrition and sleep hygiene. They also explore when
neuromodulation treatments should be considered and what should be
done when a patient doesn't respond to initial treatments or develops
treatment-resistant depression.
"Many well-established psychological and behavioral interventions have
accumulated more support for their efficacy across different delivery
formats," says co-author Dr. Lena Quilty, associate professor of
psychiatry at the University of Toronto and senior scientist at the
Centre for Addiction and Mental Health.
"We are especially pleased to report on evidence for new interventions
that target depression as well as commonly co-occurring challenges
such as anxiety or disrupted cognitive processes. We hope that these
additional alternatives provide more opportunities for integrated
attention to these multi-faceted issues."
**More information:** Raymond W. Lam et al, Canadian Network for Mood
and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for
Management of Major Depressive Disorder in Adults: Réseau canadien
pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023 : Mise
à jour des lignes directrices cliniques pour la prise en charge du
trouble dépressif majeur chez les adultes, _The Canadian Journal of
Psychiatry_ (2024). DOI: 10.1177/07067437241245384
**Citation** : New guidelines for depression care emphasize patient-
centered approach in Canada (2024, May 8) retrieved 30 May 2024 from
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emphasize-patient-centered.html
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