Common Mental Disorders Depression - New Zealand Doctor

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About the guideline Foreword The New Zealand Guidelines Group Incorporated (NZGG) is a not-for-profit non-governmental organisation committed to leading the effective use of reliable evidence in the New Zealand health and disability sector. One way it shows leadership is through the production of evidence-based guidelines. Our guidelines are developed from systematic reviews of international literature. The evidence is placed within the New Zealand context, so that recommendations on best practice can be implemented by all people affected by the guideline, whether they are practitioners, consumers or policy makers. Scope of the guideline This guideline addresses the identification of common mental disorders and the management of depression in primary care in all age groups. Special issues pertaining to older adults and mental disorders in the antenatal and postnatal period are also addressed. Among young people the focus is largely on adolescents as the prevalence of mental disorders is high in this group. The guideline does not detail the management of common mental disorders other than depression. It is intended for use by all health care practitioners practising in a primary care setting, including general practitioners, practice nurses, midwives, counsellors, nurse practitioners, psychologists, psychotherapists, social workers and school nurses. While the guideline is intended to inform development of service frameworks, it does not make specific recommendations in this area. In this guideline, the term depression is used as shorthand for a disorder meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Statistical Classification of Diseases and Related Health Problems (ICD) diagnostic criteria for major depression/major depressive episode. Depressive disorder is used to refer to a condition meeting DSM or ICD diagnostic criteria for a depressive disorder (eg, major depression, dysthymia, postnatal depression). Identification of Common Mental Disorders and Management of Depression in Primary Care vii
Page 1: Identification of Common Mental Dis
Page 4 and 5: Statement of intent Evidence-based
Page 6 and 7: Endorsements Te Ao Maramatanga New
Page 8 and 9: 3.6 Clinical features of common men
Page 10 and 11: List of figures 3.1 When to refer a
Page 14 and 15: Treaty of Waitangi The New Zealand
Page 16 and 17: Karin Keith Consumer Perspective Ma
Page 18 and 19: Professor Pete Ellis has received f
Page 21 and 22: Summary Key messages • Mental dis
Page 23 and 24: Summary Algorithm 2 Management of d
Page 25 and 26: Summary Algorithm 2b Management of
Page 27 and 28: 1 Background 1.1 Primary care chall
Page 29 and 30: Chapter 1 Background psychiatric ph
Page 31 and 32: Chapter 1 Background disorders were
Page 33 and 34: Chapter 1 Background Asians There h
Page 35 and 36: Chapter 1 Background Table 1.2 Prev
Page 37 and 38: Chapter 1 Background A history of d
Page 39 and 40: Chapter 1 Background been suggested
Page 41 and 42: Chapter 1 Background • age 15-24
Page 43 and 44: 2 Principles of intervention in the
Page 45 and 46: Chapter 2 Principles of interventio
Page 47: Chapter 2 Principles of interventio
Page 50 and 51: Good practice points Recognition of
Page 52 and 53: 3.3 Psychosocial assessment of youn
Page 54 and 55: Box 3.2 Asking about sexual identit
Page 56 and 57: 3.4 Further assessment where there
Page 58 and 59: The relevant evidence comprised six
Page 60 and 61: 3.6 Clinical features of common men
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Anxiety disorders The defining feat
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Concurrent symptoms of anxiety and
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In the opinion of the GDT, suspecte
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4 Management of depression in young
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Chapter 4 Management of depression
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Good practice points continued... R
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New Zealand ‘Get Checked’ progr
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Box 5.2 Verbal 2-3 question screeni
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Overall mental health A number of t
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• impact: problems impact signifi
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Box 5.4 Thresholds to determine sev
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Recommendations continued... Manage
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Overall, the evidence suggests that
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Patient report and clinical assessm
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When patients are awaiting consulta
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The GDT recommends TCAs as a first-
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should continue in this group for t
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a self-management resiliency tool a
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Exercise Primary care evidence We f
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psychological therapies were of equ
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The AHRQ (2007) health technology a
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Pharmacological therapies: issues f
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7 Special issues: women with mental
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Chapter 7 Special issues: women wit
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Good practice points Older adults A
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Common mental disorders Few studies
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Special issues: medication use Medi
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ehaviour therapies (BT), reminiscen
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Management of dementia in primary c
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The models are not mutually exclusi
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New Zealand evidence supports these
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etween primary and secondary mental
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10 Implementation 10.1 Introduction
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Chapter 10 Implementation The ‘Me
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Appendices A: Guideline development
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Appendix A Guideline development pr
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Appendix B Evidence and recommendat
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Appendix C Assessment of suicide ri
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Appendix E: Management of common me
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Appendix E Management of common men
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Appendix F Self-management resource
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Appendix G: Management of common me
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Appendix H: Assessing for cognitive
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Delirium Delusion Dementia Depressi
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Mania continued... Mate Mäori Mela
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Statistical significance Stepped ca
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19. Durie M. Whaiora: Maori health
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55. Patton R, Crawford M, Touquet R
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89. Caspi A, Moffitt TE, Newman DL,
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126. Pearce J, Barnett R, Collings
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161. Kawana D, Wharemate R, Ihimaer
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197. Turner KMT, Sanders MR. Help w
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232. Mathai J, Anderson P, Bourne A
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267. Weisz JR, Jensen-Doss A, Hawle
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301. Goodyear-Smith F, Arroll B, Su
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335. Teasdale JD, Segal ZV, William
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370. Kaltenthaler E, Brazier J, De
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402. McPartlin GM, Reynolds A, Ande
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434. Moore GA, Cohn JF, Campbell SB
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469. Nordeng H, Spigset O. Treatmen
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503. Yoshida K, Smith B, Craggs M,
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539. Teri L, McKenzie G, LaFazia D.
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574. New Zealand Guidelines Group.
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Common Mental Disorders Depression - New Zealand Doctor

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