Common Mental Disorders Depression - New Zealand Doctor

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Treaty of Waitangi The New Zealand Guidelines Group acknowledges the importance of the Treaty of Waitangi to New Zealand, and considers the treaty principles of partnership, participation and protection as central to improving Mäori health. As part of its commitment to the Treaty, NZGG explicitly involves Mäori consumers and health care practitioners in all its work. This guideline seeks to promote clinical practice that will protect and improve Mäori mental health. Mäori collaboration in the development of the guideline is described in the guideline development process section. Guideline development process The New Zealand Guidelines Group convened a Guideline Development Team (GDT) in October 2006. GDT members were nominated by a variety of stakeholder groups and are acknowledged in the next section. The GDT identified key issues and developed clinical questions to be addressed by this guideline, taking into account parameters specified by the Ministry of Health. To answer the clinical questions, NZGG’s researchers undertook a systematic literature review of the evidence, appraised the studies for quality and summarised the results. (see Appendix A: Guideline Development Process for further details). The results were presented to the GDT in the form of evidence tables (the search strategy and evidence tables are available online at http://www.nzgg.org.nz). The GDT discussed the evidence and developed graded recommendations suitable for the New Zealand context, using the considered judgment process (see Appendix B: Evidence and Recommendation Grading System). The guideline text was drafted by the project team with contributions from members of the GDT, based upon the agreed recommendations. Mäori-specific content was drafted with the help of the two Mäori members of the GDT, who met with members of the research team to discuss the final draft, and with the perspectives of Mäori members of the NZGG Board of Directors. The guideline was finalised after accounting for feedback received at consultation. viii Identification of Common Mental Disorders and Management of Depression in Primary Care
About the guideline Guideline development team Professor Tony Dowell (Chair) General Practitioner, Island Bay, Wellington Professor of Primary Health Care and General Practice, University of Otago, Wellington Invited by NZGG Tim Antric (from August 2007) Project Manager – National Depression Campaign, Wellington Mental Health Foundation of New Zealand, Auckland Nominated by the Mental Health Foundation of New Zealand Professor Bruce Arroll Professor and Head of Department, Department of General Practice and Primary Health Care, University of Auckland, Auckland Invited by NZGG Dr Clive Bensemann Psychiatrist, Mental Health Services for Older Adults, Waitemata Invited by NZGG Dr Sunny Collings Consultant Psychiatrist, Capital & Coast District Health Board, Wellington Senior Lecturer in Social Psychiatry and Population Mental Health, University of Otago, Wellington Invited by NZGG Dr John Cosgriff General Practitioner, South Auckland GP Liaison Mental Health Services, Counties Manukau District Health Board, South Auckland Nominated by the Royal New Zealand College of General Practitioners Joanna Davison Nurse Educator, Bachelor of Nursing Programme, Whitireia Community Polytechnic, Porirua Nominated by College of Nurses, Aotearoa (NZ) Inc Professor Pete Ellis Head of Department, Psychological Medicine, University of Otago, Wellington Invited by NZGG Lita Foliaki Pacific Perspective Pacific Health Manager, Waitemata District Health Board, Auckland Invited by NZGG Dr Allen Fraser Consultant Psychiatrist, Auckland Mind Psychiatric Consultants Senior Lecturer (Hon) Department of Psychiatry, University of Auckland, Auckland Chief Medical Officer, Waitemata District Health Board, North Shore City Chairman, New Zealand National Committee, RANZCP Nominated by The Royal Australian and New Zealand College of Psychiatrists Identification of Common Mental Disorders and Management of Depression in Primary Care ix
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 13: About the guideline Foreword The Ne
Page 17 and 18: About the guideline Paediatric subg
Page 19: About the guideline Royal New Zeala
Page 22 and 23: Algorithm 1 Management of depressio
Page 24 and 25: Algorithm 2a Management of severe d
Page 26 and 27: Algorithm 2c Management of mild dep
Page 28 and 29: • limited access to psychiatrists
Page 30 and 31: Asian peoples About 7% of the New Z
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Chapter 3 Recognition and assessmen
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Good practice points Management of
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Box 4.1 Whänau Ora The concept of
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If the young person/rangatahi/tamar
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Exercise There was insufficient evi
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at any timepoint. Treatment as usua
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5 Recognition and assessment of com
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6 Management of depression in adult
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Chapter 6 Management of depression
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Recommendations continued... Women
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during pregnancy, of which up to 6%
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Secondary care evidence Based on ev
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Advice for women It may be helpful
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Social networks appear to be an inf
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eastfeeding, or not breastfeeding,
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This evidence comprised two recent
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There is also some evidence that th
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8 Special issues: older adults/ kor
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Chapter 8 Special issues: older adu
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9 Models of care 9.1 Introduction V
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Chapter 9 Models of care were reduc
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Chapter 9 Models of care • networ
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Chapter 9 Models of care service as
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Quality improvement collaboratives
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NZGG has been funded to develop sum
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Appendix A: Guideline development p
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Appendix B: Evidence and recommenda
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Appendix C: Assessment of suicide r
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Appendix D: Assessment tools for co
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Anxiety Anxiety is often comorbid w
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Appendix F: Self-management resourc
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Information about mental disorders
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Dysthymia Dysthymia is a chronic lo
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Glossary, abbreviations and acronym
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References 1. The MaGPIe Research G
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References 38. Tse S, Tong K, Hong
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References 72. Kendler K, Kuhn J, P
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References 107. Halligan SL, Murray
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References 143. Dejesus RS, Vickers
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References 179. Shaffer D, Scott M,
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References 215. Garralda ME, Bowman
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References 249. Zwaanswijk M, Verha
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References 283. Linde K, Berner M,
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References 318. Henkel V, Mergl R,
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References 353. Rush AJ. STAR*D: wh
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References 386. Ward E, King M, Llo
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References 417. Kirsch I, Deacon BJ
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References 451. Zigmond AS, Snaith
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References 486. Appleby L, Warner R
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References 520. Irwin M, Artin KH,
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References 557. Agnew F, Pulotu-End
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www.nzgg.co.nz www.moh.govt.nz
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Common Mental Disorders Depression - New Zealand Doctor

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