Glenda M MacQueen1, Benicio N Frey2, Zahinoor Ismail3, Natalia Jaworska4, Meir Steiner2, Ryan J Van Lieshout2, Sidney H Kennedy5, Raymond W Lam6, Roumen V Milev7, Sagar V Parikh8, Arun V Ravindran5. 1. Department of Psychiatry, University of Calgary, Calgary, Alberta gmmacque@ucalgary.ca. 2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario. 3. Department of Psychiatry, University of Calgary, Calgary, Alberta. 4. Department of Psychiatry, McGill University, Montréal, Quebec. 5. Department of Psychiatry, University of Toronto, Toronto, Ontario. 6. Department of Psychiatry, University of British Columbia, Vancouver, British Columbia. 7. Department of Psychiatry, Queen's University, Kingston, Ontario. 8. Department of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Abstract
BACKGROUND: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on "Special Populations" is the sixth of six guidelines articles. RESULTS: Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. CONCLUSIONS: Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.
BACKGROUND: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on "Special Populations" is the sixth of six guidelines articles. RESULTS: Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. CONCLUSIONS: Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.
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Authors: Sidney H Kennedy; Raymond W Lam; Roger S McIntyre; S Valérie Tourjman; Venkat Bhat; Pierre Blier; Mehrul Hasnain; Fabrice Jollant; Anthony J Levitt; Glenda M MacQueen; Shane J McInerney; Diane McIntosh; Roumen V Milev; Daniel J Müller; Sagar V Parikh; Norma L Pearson; Arun V Ravindran; Rudolf Uher Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
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