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Depression Research Update: March 2016

Depression Research Update: March 2016

  • The guidelines and research discussed in this slideshow assess the benefits of various therapies for depressive disorders.[1-3] Scroll through the slides for recommendations, findings, and take-home messages.
  • •Cognitive behavioral therapy (CBT) is as effective as antidepressants in treating depression, according to new guidelines
    •FDA proposes that electroconvulsive therapy (ECT) should be reclassified from a high-risk to a low-risk intervention for major depressive disorder (MDD)
    •Dialectical behavior therapy (DBT) adapted for adolescents significantly reduces self-harm and rapidly leads to recovery

  • Either CBT or second-generation antidepressants are recommended for patients with MDD, according to the American College of Physicians.[1] See: Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: a clinical practice guideline from the American College of Physicians

  • Basis for recommendation: A systematic review of randomized controlled trials from 1990 through mid-2015 evaluated psychotherapies, complementary and alternative medicines, exercise, and second-generation antidepressants.

  • Take-home message: The guidelines strongly recommend CBT or antidepressants after a discussion of treatment effects, adverse effects, cost, accessibility, and preferences with the patient.

  • The FDA has proposed that ECT should be reclassified from a high-risk to a low-risk intervention for severe major depressive episodes associated with MDD or bipolar disorder in patients aged 18 years and older who are treatment-resistant or who require a rapid response because of the severity of their psychiatric or medical condition.[2] See: Electroconvulsive therapy (ECT) devices for class II intended uses draft guidance for industry, clinicians and Food and Drug Administration staff

  • Finding: The FDA’s draft guidance on the proposed reclassification notes “the probable benefit to health from use of the device outweighs the probable injury or illness from such use.”

  • Take-home message: ECT is a safe, effective option for appropriate patients and should be considered a low-risk procedure.

  • DBT adapted for adolescents may be a favorable treatment alternative for teenagers with repetitive self-harming behavior.[3] See: Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: outcomes over a one-year follow-up.

  • Study design: Researchers conducted a 1-year prospective follow-up study of post-treatment clinical outcomes in 77 adolescents with recent and repetitive self-harm. The participants were randomly allocated to receive 19 weeks of either DBT adapted for adolescents or enhanced usual care.

  • Take-home message: DBT adapted for adolescents led to a stronger long-term reduction in self-harm and a more rapid recovery in suicidal ideation, depression, and borderline symptoms than enhanced usual care.

The guidelines and research discussed in this slideshow assess the benefits of various therapies for depressive disorders.1-3 Scroll through the slides for recommendations, findings, and take-home messages.

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