CG123 Common mental health disorders - National Institute for ...

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Further assessment of risk and need for treatment, and routine outcome monitoringTable 26: Study information table for systematic reviews of predictors of responseStudy ID DODD2004 FEKADU2009 HARDEVELD2010 MITCHELL2005 NELSON2009 POMPILI2009Predictor Biological, Clinical factors Psychosocial and Age Presence of Psychosocial andpsychosocial, clinical factors anxiety clinical factorsclinical factorsOutcome Response to Treatment response/ Recurrence of major Treatment response Response to second Medicationantidepressant readmission depressive disorder and remission/ generation adherencetreatment (MDD) recurrence of antidepressantdepression treatmentMethod used to Narrative Narrative Narrative Narrative Meta-analysis NarrativesynthesiseevidenceDesign of Preference for Observational and Naturalistic Comparative studies Randomised, Primary research,included studies clinically relevant longitudinal longitudinal study of mid- and late-life double-blind review articles andprimary research (minimum (minimum follow-up first-epsiode placebo-controlled descriptive papersarticles follow-up 6 months) 6 months and depression (minimum trials that measuredsample size of 50) sample size of 20 in adherenceeach group)Dates searched 1966 to 2004 Inception to 2008 1980 to 2008 1966 to 2004 1966 to 2006 1975 to 2009Diagnosis Depression Treatment-resistant MDD Depression Late-life depression Unipolar anddepression bipolar depressionNo. of included 95 9 (4 with relevant 27 36 primary articles 10 104studies data)Review quality High risk of bias (only Low risk bias Low risk of bias Low risk of bias Low risk of bias Moderate risk ofMEDLINE searched, bias (quality ofquality of included included studies notstudies not assessed/ assessed/reported)reported, poordescription ofmethodology)147
Further assessment of risk and need for treatment, and routine outcome monitoring6.3.4 Summary of evidence from existing NICE guidelinesRecommendations from existing NICE guidelines relevant to common mental healthdisorders were summarised for the purposes of the GDG and synthesised using tabulation.Each guideline was examined for potentially relevant recommendations andthese were categorised into the following themes: illness severity, duration andresponse to treatment (Table 27), disorder subtype (Table 28), comorbidities (Table29), previous illness (Table 30), previous response to treatment (Table 31), personalcharacteristics (Table 32) and service user preference (Table 33). Some of the recommendationshave been reproduced as they appeared in the original guidelines; othershave been condensed and summarised for the purposes of this review and to aid theGDG. The synthesis was then used to inform the method of adoption and adaptationof existing NICE guideline recommendations.Table 27: Preliminary summary and synthesis of recommendations relating toillness severity, duration or response to treatment (by guideline) to support theprocess of adoption and adaptationGuidelineSelected text from recommendationsAlcohol-use None identifiedDisorders (NICE,2011b)Antenatal and For women with symptoms of depression and/or anxietyPostnatal Mental that do not meet diagnostic criteria but significantlyHealth (NICE, interfere with personal and social functioning, consider:2007a) • individual brief psychological treatment (four to six(For common sessions), IPT or CBT for women with a previousmental health episode of anxiety/depressiondisorders only) • social support for example, regular informal individualor group-based support for women who have not had aprevious episode of depression or anxiety.Mild-moderate depression during pregnancy/the postnatalperiod, consider:• self-help strategies• non-directive counselling at home• brief CBT• IPT.Mild depressionIf a woman is taking an antidepressant for current milddepression, the medication should be withdrawn graduallyand monitoring considered. If intervention is then needed,consider:• self-help approaches• brief psychological treatment.148Continued
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Access to healthcarepractitioners h
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Access to healthcareIndividual-leve
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Access to healthcarefrom such popul
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Access to healthcarestructure and d
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Case identification and formal asse
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Case identification and formal asse
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Systems for organising and developi
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendations●●a g
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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