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Updated NICE guidelines on treating depression

NICE - the UK National Institute for Health and Clinical Excellence - recently published guidance on "Depression in adults (update)" and on "Depression with a chronic physical health problem".  The "Depression in adults (update)"  replaces guidance originally published in 2004 and amended in 2007.  The 28 page Quick reference guide provides a helpful overview.  Interestingly NICE here use the DSM-IV diagnostic criteria for depression rather than the ICD-10 criteria (used in their earlier publications).  A four step approach is charted - each step is described both by who the intervention is for (e.g.

Recent research: five papers on depression, stigma, biology, & extending the reach of psychotherapy

This set of five papers documents, in part, our mixed viewpoints on depression.  Worryingly, Mehta & colleagues show deteriorating public attitudes towards mental illness in England (and to a lesser extent Scotland) between 1994 and 2003.  Meanwhile Blumner et al demonstrate a shift towards a more biological view on causes and treatment of depression in the US between 1996 and 2006.

In contrast, Miranda et al's editorial (and Grote et al's research) highlight the growing evidence showing psychotherapies for depression can be "very effective for low-income and minority populations in the United States and abroad" - extending their validity well beyond more privileged groups in developed countries.  Andersson too discusses a further way to make psychotherapies more widely available and helpful - in this case, the increasing literature documenting the widespread value of delivering cognitive behavioural therapy via the internet.     

Draft SIGN non-pharmacological depression treatments guideline, 8th post: therapeutic alliance in the treatment of depression

There was some discussion at the SIGN "Non-pharmacological management of depression" seminar about the possible importance of the therapeutic alliance in depression treatment.  Profe

Draft SIGN non-pharmacological depression treatments guideline, 7th post: effectiveness of psychological therapies 2

This is the 7th blog post in a series reviewing the recent Scottish Intercollegiate Guideline Network's (SIGN) draft guideline for "Non-pharmacological management of depression".  I gave more background details in the first post of the series.  This post covers the third session of the guideline presentation seminar.  The session was entitled "Effectiveness of psychological therapies in depression 2" and there were three speakers.  Professor Kevin Power, Area Head of Psychological Therapies, NHS Tayside, talked about "Counselling, marital, family and reminiscence therapy".  Kevin said there were comparatively few good randomized controlled trials on counselling interventions specifically for patients diagnosed with major depressive disorder.  SIGN gave a Grade

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