scholarly journals Improvements in the degree of understanding the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study

2021 ◽  
Author(s):  
Shusuke Numata ◽  
Masahito Nakataki ◽  
Naomi Hasegawa ◽  
Yoshikazu Takaesu ◽  
Masahiro Takeshima ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Guidelines ◽  
Dissemination And Implementation ◽  
Implementation Study ◽  
Major Depressive

scholarly journals Improvements in the degree of understanding the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study

2020 ◽  
Author(s):  
Shusuke Numata ◽  
Masahito Nakataki ◽  
Naomi Hasegawa ◽  
Yoshikazu Takaesu ◽  
Masahiro Takeshima ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Correct Answer ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
The Other ◽  
Dissemination And Implementation ◽  
Implementation Study ◽  
Clinical Knowledge ◽  
Major Depressive

Abstract Background: To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of existing CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs, including one for schizophrenia and one for major depressive disorder (MDD).Methods: A total of 413 psychiatrists (n=212 in 2016; n=201 in 2017) learned the two CPGs in the education program of the EGUIDE project over two days, and clinical knowledge of the two CPGs was evaluated by two 37-item questionnaires at baseline and after the EGUIDE programs. To improve the correct answer rate for clinical knowledge after the EGUIDE programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers for each item after the EGUIDE programs were compared between the 2016 and 2017 groups.Results: The total clinical knowledge scores significantly increased after the EGUIDE program in both the 2016 groups and the 2017 groups. We revised lecture materials related to two items in the schizophrenia CPG and five items in the MDD CPG that had low correct answer rates after the EGUIDE programs. The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG were increased (S-D5, p=0.038; D-C6, p=0.033) and that of one item on the MDD CPG was significantly improved (D-D3, p=0.00080) in the 2017 group compared to the rates of the 2016 group. The correct response rates of the other four items were not significantly improved.Conclusions: We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revisions of the lecture materials based on the results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.Trial registration: Effectiveness of Guideline for Dissemination and Education in Psychiatric Treatment, UMIN000022645, Registered 15 June 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000026044&type=summary&language=J

scholarly journals Improvements in the Degree of Understanding the Treatment Guidelines for Schizophrenia and Major Depressive Disorder in a Nationwide Dissemination and Implementation Study

2020 ◽  
Author(s):  
Shusuke Numata ◽  
Masahito Nakataki ◽  
Naomi Hasegawa ◽  
Yoshikazu Takaesu ◽  
Masahiro Takeshima ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Correct Answer ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
The Other ◽  
Dissemination And Implementation ◽  
Implementation Study ◽  
Clinical Knowledge ◽  
Major Depressive

Abstract Background: To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of the CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs for schizophrenia and major depressive disorder (MDD).Methods: A total of 413 psychiatrists (n=212 in 2016; n=201 in 2017) learned the two CPGs in the education program of the EGUIDE project over two days, and clinical knowledge of the two CPGs was evaluated by two 37-item questionnaires at baseline and after the EGUIDE programs. To improve the correct answer rate for clinical knowledge after the EGUIDE programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers after the EGUIDE programs for each item between the 2016 and 2017 groups were compared.Results: The total clinical knowledge scores after the EGUIDE program significantly increased in both the 2016 groups and the 2017 groups. We revised lecture materials related to two items in the schizophrenia CPG and five items in the MDD CPG that had low correct answer rates after the EGUIDE programs. The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG tended to be improved (S-D5, p=0.038; D-C6, p=0.033) and that of one on the MDD CPG was significantly improved (D-D3, p=0.00080) in the 2017 group compared to those in the 2016 group. The other four items were not significantly improved.Conclusions: We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revision of the lecture materials based on results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.Trial registration: Effectiveness of Guideline for Dissemination and Education in Psychiatric Treatment, UMIN000022645, Registered 15 June 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000026044&type=summary&language=J

scholarly journals Efficacy of brief dynamic interpersonal therapy in patients with major depressive disorder: a prospective, multicenter randomized controlled trial protocol

2020 ◽  
Author(s):  
Lanlan Wang ◽  
Qian Wang ◽  
Wenhui Jiang ◽  
Jianfeng Luo ◽  
Jun Tong ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Treatment Phase ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Abstract Background: In China, psychodynamic psychotherapies are widely used as a treatment for depression. However, very few efficacy studies of psychodynamic therapies have been conducted with the Chinese population. This paper describes a study protocol of a multicenter randomized controlled trial of Dynamic Interpersonal Psychotherapy (DIT), a brief manualized depression-focused intervention, in Chinese adults with major depressive disorder (MDD). Methods: Recruitmemt is planned in five hospitals. 240 patients with MDD will be randomly allocated on a 1:1:1 basis to either medication plus DIT, medication plus an active control psychotherapy, or medication alone. Patients will be assessed at baseline and at weeks 2, 4, 8, 12, 16 during the acute treatment phase, and 1, 3, 6 and 12 months posttreatment. The primary outcome is change from baseline in the 17-item Hamilton Depression Rating Scale, administered by independent raters who are blind to treatment allocation. The Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item scale, response, remission and relapse rates, self-assessment of overall efficacy and satisfaction of patients, and side effect profiles are secondary measures. Discussion: This will be the first multicentered RCT in China to assess the efficacy of a brief psychodynamic intervention for MDD. The study has the potential to inform clinical treatment guidelines for the treatment of depression in China. Trial registration: ChiCTR，ChiCTR1800016970， Registered on July 5th 2018. Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=28786.

The Potential Role of Pharmacogenomics in Optimizing Drug Regimens for Older People with Major Depressive Disorder

2021 ◽  
Vol 36 (6) ◽  
pp. 276-282
Author(s):  
Jarvett M. Cox ◽  
Leisa L. Marshall
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Older People ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Guidelines ◽  
Older Individuals ◽  
Major Depressive ◽  
First Line Therapy ◽  
Drug Regimens ◽  
Older Populations

Major depressive disorder (MDD) is a mood disorder common in older individuals. While many clinical guidelines endorse the use of selective serotonin reuptake inhibitors (SSRIs) as first-line therapy in the treatment of MDD, the use of SSRIs in older populations can result in medication-related adverse events. The use of pharmacogenomic (PGx) testing as a personalized tool to determine optimal SSRI therapy could offer a means to decrease morbidity and improve overall quality of life in older people. This manuscript will review the epidemiology and criteria of MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), discuss the prevalence of MDD in older individuals, review the clinical treatment guidelines for the use of SSRIs in MDD, provide a brief overview of PGx testing, and present evidence for SSRI therapy modifications based on PGx testing.

scholarly journals Clinical Correlates and Outcome of Major Depressive Disorder and Comorbid Migraine: A Report of the European Group for the Study of Resistant Depression

2020 ◽  
Vol 23 (9) ◽  
pp. 571-577
Author(s):  
Gernot Fugger ◽  
Markus Dold ◽  
Lucie Bartova ◽  
Marleen M M Mitschek ◽  
Daniel Souery ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Functional Disability ◽  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Clinical Information ◽  
Binary Logistic Regression ◽  
Major Depressive ◽  
Caucasian Origin ◽  
Male Patients

Abstract Background The present multicenter study aimed at defining the clinical profile of patients with major depressive disorder (MDD) and comorbid migraine. Methods Demographic and clinical information for 1410 MDD patients with vs without concurrent migraine were compared by descriptive statistics, analyses of covariance, and binary logistic regression analyses. Results The point prevalence rate for comorbid migraine was 13.5% for female and 6.2% for male patients. MDD + migraine patients were significantly younger, heavier, more likely female, of non-Caucasian origin, outpatient, and suffering from asthma. The presence of MDD + migraine resulted in a significantly higher functional disability. First-line antidepressant treatment strategy revealed a trend towards agomelatine. Second-generation antipsychotics were significantly less often administered for augmentation treatment in migraineurs. Overall, MDD + migraine patients tended to respond worse to their pharmacotherapy. Conclusion Treatment guidelines for comorbid depression and migraine are warranted to ensure optimal efficacy and avoid possible pitfalls in psychopharmacotherapy, including serotonin syndrome.

Factors Impacting the Selection of Antidepressant Treatment in Patients With Major Depressive Disorder at Risk for Nonadherence

CNS Spectrums ◽  
2009 ◽  
Vol 14 (S12) ◽  
pp. 15-19 ◽  
Author(s):  
Charles Shelton
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Guidelines ◽  
Patient Adherence ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Patient Nonadherence ◽  
Subsequent Relapse ◽  
Selection Of

AbstractTreatment with the newer generation antidepressants is considered generally effective for most patients with major depressive disorder when taken in accordance with treatment guidelines. However, multiple clinical studies have demonstrated that rates of patient adherence to antidepressants are inadequate, specifically with regard to long-term maintenance treatment. Tolerability issues associated with antidepressants can increase the risk for patient nonadherence and result in subsequent relapse of depressive symptoms. Comorbid symptoms of anxiety also influence psychiatrists' choice of antidepressants for patients with depression. Physicians can improve long-term patient outcomes for patients with major depressive disorder by considering the possibility of drug-drug interactions before prescribing a specific antidepressant.

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