title: [What is the contribution of clinical practice recommendations concerning the prevention of depressive recurrences?].
abstract: Depression has to be managed using a combination of data-driven evidence and clinical experience. Recommendations for clinical practice are various and heterogeneous, depending on their objectives. The identification of their differences can provide informations on the difficulties that we can have in treating depressed patients. Treatment guidelines for depression support both early vigorous treatment, and continued therapy after the acute phase. In recurrent depression, maintenance antidepressant therapy and regular monitoring is advised, but pharmacological strategies should be tailored to the individual for treatment that matches the phase of illness. Psychological strategies and more specifically Cognitive Behavioral Therapy should be developed to prevent relapse specifically. Relapse prevention involves putting supports in place to help the patient stay well and to reduce the likelihood of future illness. It includes developing a plan for managing early relapse symptoms and to identify potential high-risk situations. But, a large proportion of people with a depressive disorder do not receive minimally adequate treatment. Improving the concordance of everyday practice with clinical recommendations should be an important goal for clinicians.
authors.affiliation: Service de Psychiatrie B, CHU Clermont-Ferrand, Hôpital Gabriel-Montpied, Clermont-Ferrand, France. pmllorca@chu-clermontferrand.fr
authors.forename: P-M
authors.initials: PM
authors.lastname: Llorca
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D032921:Consensus; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D019983:Guideline Adherence; D006801:Humans; D008016:Life Change Events; D016651:Lithium Carbonate / Q000627:therapeutic use; D008134:Long-Term Care; D011613:Psychotherapy; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000928:Antidepressive Agents; D016651:Lithium Carbonate