Effectiveness evaluation of mood disorder treatment algorithms in Brazilian public healthcare patients

Lima, Ana Flávia Barros da Silva; Miguel, Sandro René Pinto de Sousa; Cohen, Mírian; Zimmermann, J.; Shansis, Flávio; Cruz, Luciane Nascimento; Ziegelmann, Patrícia Klarmann; Polanczyk, Carísi Anne; Fleck, Marcelo Pio de Almeida

doi:10.1590/1516-4446-2016-2147

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…Therefore, it is always recommended that protocols specific for each diagnosis be used, especially for mood disorders. 52 Rapid tranquilization, sedation, and antianxiety agents Studies that assess the safety and effectiveness of sedative medications, rapid tranquilization, and even the use of anxiolytics in suicidal behavior are lacking. Therefore, each case must be evaluated separately.…”

Section: Clozapine and Other Antipsychoticsmentioning

confidence: 99%

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Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention

Baldaçara

Grüdtner

Leite

et al. 2021

Braz. J. Psychiatry

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This article continues our presentation of the Brazilian Psychiatric Association guidelines for the management of patients with suicidal behavior, with a focus on screening, intervention, postvention, prevention, and promotion. For the development of these guidelines, we conducted a systematic review of the MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, Web of Science, and SciELO databases for research published from 1997 to 2020. Systematic reviews, clinical trials, and cohort/observational studies on screening, intervention, and prevention in suicidal behavior were included. This project involved 14 Brazilian psychiatry professionals and 1 psychologist selected by the Psychiatric Emergencies Committee of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. Publications were evaluated according to the 2011 Oxford Center for Evidence-Based Medicine (OCEBM) Levels of Evidence Classification. Eightyfive articles were reviewed (of 5,362 initially collected and 755 abstracts on the drug approach). Forms of screening, intervention, and prevention are presented. The intervention section presents evidence for psychotherapeutic and drug interventions. For the latter, it is important to remember that each medication is effective only for specific groups and should not replace treatment protocols. We maintain our recommendation for the use of universal screening plus intervention. Although the various studies differ in terms of the populations evaluated and several proposals are presented, there is already significant evidence for certain interventions. Suicidal behavior can be analyzed by evidence-based medicine protocols. Currently, the best strategy is to combine several techniques through the Safety Plan. Nevertheless, further research on the topic is needed to elucidate some approaches with particular potential for intervention and prevention.

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Section: Clozapine and Other Antipsychoticsmentioning

confidence: 99%

“…Therefore, it is always recommended that protocols specific for each diagnosis be used, especially for mood disorders. 52 …”

Section: Interventionmentioning

confidence: 99%

Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention

Baldaçara

Grüdtner

Leite

et al. 2021

Braz. J. Psychiatry

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“…This has been replicated in a Brazilian study. 27 Our model incorporates the concurrent use of three algorithms, biological, social and psychological, with different algorithms for patients who are currently in a depressive episode; in a manic, hypomanic or mixed episode; and out of episode (yielding a total of nine algorithms). The algorithms are being produced iteratively, and are based on National Institute for Health and Care Excellence (NICE) guidelines, with support as needed from other clinical guidelines – notably that produced by the British Association of Psychopharmacology 12 and by the extant evidence base.…”

Section: Algorithm Based Carementioning

confidence: 99%

Changing practice: assessing attitudes toward a NICE-informed collaborative treatment pathway for bipolar disorder

et al. 2021

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Background Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder. Aims To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder. Method Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires (n = 26) and transcription of a focus group, analysed qualitatively by a framework analysis. Results Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient–clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services. Conclusions Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.

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Assessment of the psychometric properties of the 17- and 6-item Hamilton Depression Rating Scales in major depressive disorder, bipolar depression and bipolar depression with mixed features

Silva

Reche

Lima

et al. 2019

Journal of Psychiatric Research

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Effectiveness evaluation of mood disorder treatment algorithms in Brazilian public healthcare patients

Abstract: NCT02901249, NCT02870283, NCT02918097.

Cited by 4 publications

References 39 publications

Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention

Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention

Changing practice: assessing attitudes toward a NICE-informed collaborative treatment pathway for bipolar disorder

Assessment of the psychometric properties of the 17- and 6-item Hamilton Depression Rating Scales in major depressive disorder, bipolar depression and bipolar depression with mixed features

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