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Guidelines’ recommendations for the treatment-resistant depression: A systematic review of their quality

2023Artigo científico Acesso aberto
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dc.contributor.authorGabriel, Franciele Cordeiro
dc.contributor.authorStein, Airton Tetelbom
dc.contributor.authorMelo, Daniela de Oliveira
dc.contributor.authorFontes-Mota, Gessica Caroline Henrique
dc.contributor.authordos Santos, Itamires Benício
dc.contributor.authorRodrigues, Camila da Silva
dc.contributor.authorDourado, Andrea
dc.contributor.authorRodrigues, Mônica Cristiane
dc.contributor.authorFráguas, Renério
dc.contributor.authorFlorez, Ivan D.
dc.contributor.authorTelles-Correia, Diogo
dc.contributor.authorRibeiro, Eliane
dc.date.accessioned2023-02-07T13:47:24Z
dc.date.available2023-02-07T13:47:24Z
dc.date.issued2023
dc.descriptionCopyright: © 2023 Gabriel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.pt_PT
dc.description.abstractIntroduction: Depression is a serious and widespread mental health disorder. A significant proportion of patients with depression fail to remit after two antidepressant treatment trials, a condition named treatment-resistant depression (TRD). Clinical practice guidelines (CPGs) are instruments aimed to improve diagnosis and treatment. This study objective is to systematically appraise the quality and elaborate a comparison of high-quality CPGs with high-quality recommendations aimed at TRD. Methods and analysis: We searched several specialized databases and organizations that develop CPGs. Independent researchers assessed the quality of the CPGs and their recommendations using AGREE II and AGREE-REX instruments, respectively. We selected only high-quality CPGs that included definition and recommendations for TRD. We investigated their divergencies and convergencies as well as weak and strong points. Results: Among seven high-quality CPGs with high-quality recommendations only two (Germany's Nationale Versorgungs Leitlinie-NVL and US Department of Veterans Affairs and Department of Defense-VA/DoD) included specific TRD definition and were selected. We found no convergent therapeutic strategy among these two CPGs. Electroconvulsive therapy is recommended by the NVL but not by the VA/DoD, while repetitive transcranial magnetic stimulation is recommended by the VA/DoD but not by the NVL. While the NVL recommends the use of lithium, and a non-routine use of thyroid or other hormones, psychostimulants, and dopaminergic agents the VA/DoD does not even include these drugs among augmentation strategies. Instead, the VA/DoD recommends ketamine or esketamine as augmentation strategies, while the NVL does not mention these drugs. Other differences between these CPGs include antidepressant combination, psychotherapy as a therapeutic augmentation, and evaluation of the need for hospitalization all of which are only recommended by the NVL. Conclusions: High-quality CPGs for the treatment of depression diverge regarding the definition and use of the term TRD. There is also no convergent approach to TRD from currently high-quality CPGs.pt_PT
dc.description.sponsorshipF.C.G. is a fellow of the Conselho Nacional de Pesquisa e Tecnologia (CNPq, grant number 141811/2020-0).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPLoS One. 2023 Feb 6;18(2):e0281501pt_PT
dc.identifier.doi10.1371/journal.pone.0281501pt_PT
dc.identifier.eissn1932-6203
dc.identifier.urihttp://hdl.handle.net/10451/56203
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontierspt_PT
dc.relation.publisherversionhttps://journals.plos.org/plosone/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.titleGuidelines’ recommendations for the treatment-resistant depression: A systematic review of their qualitypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue2pt_PT
oaire.citation.titlePLOS ONEpt_PT
oaire.citation.volume18pt_PT
person.familyNameTelles-Correia
person.givenNameDiogo
person.identifier82027
person.identifier.ciencia-idB219-3860-D2C5
person.identifier.orcid0000-0003-4217-2823
person.identifier.scopus-author-id15030253900
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication7eec6382-2f4a-45b0-b4be-7b6ac9a77786
relation.isAuthorOfPublication.latestForDiscovery7eec6382-2f4a-45b0-b4be-7b6ac9a77786

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