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.
Clinical Epidemiology Center (CepiC), University Hospital, Lausanne, Switzerland.
Rachel
R
Voellinger
Alexandre
A
Berney
Pierre
P
Baumann
Jean Marie
JM
Annoni
Christian
C
Bryois
Thierry
T
Buclin
Christophe
C
Büla
Vincent
V
Camus
Laurent
L
Christin
Jacques
J
Cornuz
Pierre
P
de Goumoëns
Olivier
O
Lamy
Jindrich
J
Strnad
Bernard
B
Burnand
Frederic
F
Stiefel
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