加拿大情绪与焦虑治疗网络 (CANMAT) 2023 年成人重度抑郁障碍管理临床指南更新:加拿大情绪与焦虑治疗网络 (CANMAT) 2023 年成人重度抑郁障碍管理临床指南更新。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-09-01 Epub Date: 2024-05-06 DOI:10.1177/07067437241245384
Raymond W Lam, Sidney H Kennedy, Camelia Adams, Anees Bahji, Serge Beaulieu, Venkat Bhat, Pierre Blier, Daniel M Blumberger, Elisa Brietzke, Trisha Chakrabarty, André Do, Benicio N Frey, Peter Giacobbe, David Gratzer, Sophie Grigoriadis, Jeffrey Habert, M Ishrat Husain, Zahinoor Ismail, Alexander McGirr, Roger S McIntyre, Erin E Michalak, Daniel J Müller, Sagar V Parikh, Lena S Quilty, Arun V Ravindran, Nisha Ravindran, Johanne Renaud, Joshua D Rosenblat, Zainab Samaan, Gayatri Saraf, Kathryn Schade, Ayal Schaffer, Mark Sinyor, Claudio N Soares, Jennifer Swainson, Valerie H Taylor, Smadar V Tourjman, Rudolf Uher, Michael van Ameringen, Gustavo Vazquez, Simone Vigod, Daphne Voineskos, Lakshmi N Yatham, Roumen V Milev
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引用次数: 0

摘要

背景:加拿大情绪与焦虑治疗网络(CANMAT)上一次发布重度抑郁障碍(MDD)临床治疗指南是在2016年。由于该领域的进步,需要更新指南以纳入新的证据,并为成人重度抑郁障碍的评估和管理提供新的和修订的建议:方法:CANMAT召集了一个由学术临床医生和患者合作伙伴组成的指南编辑小组。我们进行了系统的文献综述,重点关注自 2016 年指南发布以来发表的系统综述和荟萃分析。根据 CANMAT 定义的证据水平,并辅以临床支持(包括专家就安全性、耐受性和可行性达成的共识),按治疗方案组织了建议。根据患者合作伙伴的审查、专家同行审查和明确的专家共识程序对草案进行了修订:更新后的指南包括八个主要主题,以问答的形式描绘了从评估到选择循证治疗、预防复发以及应对反应不足的策略等患者护理过程。指南采用个性化护理方法,强调共同决策,反映出 MDD 患者的价值观、偏好和治疗史。表格提供了有关心理、药物、生活方式、补充和替代医学、数字健康和神经调节治疗的新建议和更新建议。同时还强调了证据的注意事项和局限性:CANMAT 2023》更新版指南以方便临床医生使用的形式,为 MDD 的治疗提供了以证据为依据的建议。这些更新版指南强调协作、个性化和系统化的管理方法,有助于优化成年 MDD 患者的治疗效果。
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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.

Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) last published clinical guidelines for the management of major depressive disorder (MDD) in 2016. Owing to advances in the field, an update was needed to incorporate new evidence and provide new and revised recommendations for the assessment and management of MDD in adults.

Methods: CANMAT convened a guidelines editorial group comprised of academic clinicians and patient partners. A systematic literature review was conducted, focusing on systematic reviews and meta-analyses published since the 2016 guidelines. Recommendations were organized by lines of treatment, which were informed by CANMAT-defined levels of evidence and supplemented by clinical support (consisting of expert consensus on safety, tolerability, and feasibility). Drafts were revised based on review by patient partners, expert peer review, and a defined expert consensus process.

Results: The updated guidelines comprise eight primary topics, in a question-and-answer format, that map a patient care journey from assessment to selection of evidence-based treatments, prevention of recurrence, and strategies for inadequate response. The guidelines adopt a personalized care approach that emphasizes shared decision-making that reflects the values, preferences, and treatment history of the patient with MDD. Tables provide new and updated recommendations for psychological, pharmacological, lifestyle, complementary and alternative medicine, digital health, and neuromodulation treatments. Caveats and limitations of the evidence are highlighted.

Conclusions: The CANMAT 2023 updated guidelines provide evidence-informed recommendations for the management of MDD, in a clinician-friendly format. These updated guidelines emphasize a collaborative, personalized, and systematic management approach that will help optimize outcomes for adults with MDD.

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