CANMAT Guidelines for depression: Clear and user-friendly

Anderson, Ian M.; Haddad, Peter M.

doi:10.1016/j.jad.2009.06.045

Cited by 10 publications

(7 citation statements)

References 3 publications

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“…Most guidelines have similar features, including attempts to systematically review the evidence, the involvement of a guideline development group or consensus meeting, the use of operationalized levels of evidence, and a review process prior to finalization (Lam et al ., ; NICE, ; APA, ). A major problem for depression treatment guidelines is the large amount of evidence to synthesize and the fact that they are often fuelled by different meta‐analyses (Anderson and Haddad, ). Some guides use a question‐and‐answer format with sections in terms of first‐, second‐, and third‐line treatment alternatives, while others have a narrative structure with subsections.…”

Section: Discussionmentioning

confidence: 99%

Use of antidepressants in the treatment of depression in Asia: Guidelines, clinical evidence, and experience revisited

Treuer¹,

Liu

Salazar³

et al. 2013

Asia-Pacific Psychiatry

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Major depressive disorder is prevalent worldwide, and only about half of those affected will experience no further episodes or symptoms. Additionally, depressive symptoms can be challenging to identify, with many patients going undiagnosed despite a wide variety of available treatment options. Antidepressants are the cornerstone of depression treatment; however, a large number of factors must be considered in selecting the treatment best suited to the individual. To help support physicians in this process, international and national treatment guidelines have been developed. This review evaluates the current use of antidepressant treatment for major depressive disorder in six Asian countries (China, Korea, Malaysia, Philippines, Taiwan, and Thailand). No remarkable differences were noted between Asian and international treatment guidelines or among those from within Asia as these are adapted from western guidelines, although there were some local variations. Importantly, a shortage of evidence-based information at a country level is the primary problem in developing guidelines appropriate for Asia, so most of the guidelines are consensus opinions derived from western research data utilized in western guidelines. Treatment guidelines need to evolve from being consensus based to evidence based when evidence is available, taking into consideration cost/effectiveness or cost/benefit with an evidence-based approach that more accurately reflects clinical experience as well as the attributes of each antidepressant. In everyday practice, physicians must tailor their treatment to the patient's clinical needs while considering associated external factors; better tools are needed to help them reach the best possible prescribing decisions which are of maximum benefit to patients.

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Section: Discussionmentioning

confidence: 99%

Use of antidepressants in the treatment of depression in Asia: Guidelines, clinical evidence, and experience revisited

Treuer¹,

Liu

Salazar³

et al. 2013

Asia-Pacific Psychiatry

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“…[19][20][21][22][23][24][25][26] These CANMAT guidelines were written after a systematic review of the literature following principles of EBM, grading the evidence in favour of large placebo-controlled RCTs and meta-analyses. 27,28 Similarly, the Canadian Psychiatric Association has produced clinical guidelines on treatment of specifi c disorders, which leave latitude to the clinician, without mention of EBPs. This situation is similar at the provincial level, with observers early on and more recently noting that Canadian jurisdictions are not identifying EBPs or providing them to their populations.…”

Section: Ebm In Canadian Psychiatrymentioning

confidence: 99%

Evidence-Based Medicine: Opportunities and Challenges in a Diverse Society

2011

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In this article we explore the discourse and practice of evidence-based medicine (EBM) in the context of social and cultural diversity. The article consists of 2 parts. First, we begin by defining EBM, describing its historical development and current ascendance in medical practice. We then note its importance in contemporary psychiatry, comparing dynamics between the United States and Canada. Secondly, we offer a constructive critique of the application of EBM and evidence-based practices in the context of ethnocultural diversity, as one consistent reflection on the EBM literature is that it is does not adequately address issues of diversity. In doing so, we use the situation here in Canada as an extended case study, though our observations will likely be applicable in other diverse nations, such as the United States, the United Kingdom, and Australia. We critically examine the following 6 issues related to the practice of EBM in a diverse society: generalizability and transferability of evidence-based interventions; diversifying standards of evidence in EBM; strategies to address diversity in EBM research; cultural adaptations of evidence-based interventions; integrating idiographic knowledge; and, training and health service delivery. Concurrent with our critique, we offer research and practice suggestions that may address outstanding challenges vis-à-vis the practice of EBM in a diverse society. These include a need for more effectiveness research, more openness to diverse sources of knowledge, better integration of idiographic and nomothetic knowledge, and a critical approach to extrapolation and transfer of knowledge.

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“…[7][8][9][10] Increased emphasis on strategies that aim to improve access to and receipt of evidence-based treatment could improve the well-being of people living with these disorders. 11 Treatments come in many forms, ranging from the more established therapies such as pharmacotherapy and psychotherapy, [12][13][14] to newer treatments (used either alone or https://doi.org/10.24095/hpcdp. 37.5.04 as an adjunct) such as Internet-based cognitive behavioural therapy (CBT), 15 herbal therapies, 16 meditation 17 and physical activity/exercise.…”

Section: Introductionmentioning

confidence: 99%