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McQuaid JR, Buelt A, Capaldi V, Fuller M, Issa F, Lang AE, Hoge C, Oslin DW, Sall J, Wiechers IR, Williams S. The Management of Major Depressive Disorder: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Ann Intern Med 2022; 175:1440-1451. [PMID: 36122380 DOI: 10.7326/m22-1603] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
DESCRIPTION In February 2022, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved a joint clinical practice guideline (CPG) for the management of major depressive disorder (MDD). This synopsis summarizes key recommendations. METHODS Senior leaders within the VA and the DoD assembled a team to update the 2016 CPG for the management of MDD that included clinical stakeholders and conformed to the National Academy of Medicine's tenets for trustworthy CPGs. The guideline panel developed key questions, systematically searched and evaluated the literature, created two 1-page algorithms, and distilled 36 recommendations for care using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Select recommendations that were identified by the authors to represent key changes from the prior CPG are presented in this synopsis. RECOMMENDATIONS The scope of the CPG is diverse; however, this synopsis focuses on key recommendations that the authors identified as important new evidence and changes to prior recommendations on pharmacologic management, pharmacogenomics, psychotherapy, complementary and alternative therapies, and the use of telemedicine.
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Affiliation(s)
- John R McQuaid
- San Francisco VA Health Care System, and Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California (J.R.M.)
| | - Andrew Buelt
- C.W. Bill Young Veterans Administration Medical Center, Bay Pines, Florida (A.B.)
| | - Vincent Capaldi
- Uniformed Services University of the Health Sciences, Bethesda, Maryland (V.C.)
| | - Matthew Fuller
- VHA Pharmacy Benefits Management Services, U.S. Department of Veterans Affairs, Mentor, Ohio, and Case Western Reserve University, Cleveland, Ohio (M.F.)
| | - Fuad Issa
- Defense Health Agency, Silver Spring, Maryland (F.I.)
| | - Adam Edward Lang
- Department of Primary Care, McDonald Army Health Center, Fort Eustis, Virginia, and Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, Virginia (A.E.L.)
| | - Charles Hoge
- Walter Reed Army Institute of Research, Silver Spring, Maryland (C.H.)
| | - David W Oslin
- Corporal Michael J. Crescenz VA Medical Center, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (D.W.O.)
| | - James Sall
- Veterans Administration Central Office, Washington, DC (J.S.)
| | - Ilse R Wiechers
- Office of Mental Health and Suicide Prevention, Department of Veterans Affairs, and Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California (I.R.W.)
| | - Scott Williams
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, and School of Medicine, Case Western Reserve University, Cleveland, Ohio (S.W.)
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Tavares ACDS, Lima RFF, Tokumaru RS. Teorias evolucionistas da depressão: panorama e perspectivas. PSICOLOGIA USP 2021. [DOI: 10.1590/0103-6564e200003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo A depressão tem alcançado níveis epidêmicos ao redor do mundo. Seria a depressão um distúrbio mental, como é consenso na saúde mental? Teóricos evolucionistas têm-se questionado quanto à função da depressão e proposto modelos específicos para explicá-la. O objetivo deste artigo é apresentar teorias evolucionistas da depressão, discutir as relações de complementariedade e contraposição entre elas e as implicações sociais e práticas para o tratamento da depressão. Essas reflexões e questionamentos no domínio da saúde mental podem influenciar novos estudos a partir de uma perspectiva não patológica da depressão. No âmbito da psicologia essa perspectiva fornece subsídios para repensar a psicoterapia com o deprimido, enfocando a análise causal e a resolução de problemas. Sugere-se a realização de estudos empíricos com a finalidade de testar e sistematizar as teorias evolucionistas da depressão.
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