Major depressive disorder in the general hospital: adaptation of clinical practice guidelines.
Major Depressive Disorder is particularly frequent among physically ill inpatients. Despite the considerable human burden and financial costs, Major Depressive Disorder remains under-detected and under-treated. To improve this situation, clinical practice guidelines for the management of Major Depressive Disorder were developed for patients in the general hospital. They were adapted from existing good quality guidelines. A literature search has been conducted to identify guidelines and systematic reviews about the management of Major Depressive Disorder. The quality of the existing guidelines was evaluated by means of the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Complementary literature searches were necessary to answer questions such as "depression and physical illness" or "antidepressants and somatic medication". The guidelines were discussed by a multidisciplinary internal panel. The final version was reviewed by an external panel. This paper presents the development process and a summary of these guidelines for the management of Major Depressive Disorder. The adaptation of good quality guidelines to local needs requires much time, effort and skills. Easier ways for the adaptation and use of high quality guidelines at the local level may result from better coordination, organization and updating of guidelines at a national or supranational level.
Voellinger
Rachel
R
Clinical Epidemiology Center (CepiC), University Hospital, Lausanne, Switzerland.
Berney
Alexandre
A
Baumann
Pierre
P
Annoni
Jean Marie
JM
Bryois
Christian
C
Buclin
Thierry
T
Büla
Christophe
C
Camus
Vincent
V
Christin
Laurent
L
Cornuz
Jacques
J
de Goumoëns
Pierre
P
Lamy
Olivier
O
Strnad
Jindrich
J
Burnand
Bernard
B
Stiefel
Frederic
F
D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D017408:Guidelines as Topic; D006769:Hospitals, General; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D011787:Quality of Health Care