Clinical guidelines for the treatment of depressive disorders VII. Comorbidity

Citation
Mw. Enns et al., Clinical guidelines for the treatment of depressive disorders VII. Comorbidity, CAN J PSY, 46, 2001, pp. 77S-90S
Citations number
231
Categorie Soggetti
Psychiatry,"Clinical Psycology & Psychiatry
Journal title
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE
ISSN journal
07067437 → ACNP
Volume
46
Year of publication
2001
Supplement
S
Pages
77S - 90S
Database
ISI
SICI code
0706-7437(200106)46:<77S:CGFTTO>2.0.ZU;2-P
Abstract
Background: The Canadian Psychiatric Association and the Canadian Network f or Mood and Anxiety Treatment partnered to produce clinical guidelines for psychiatrists for the treatment of depressive disorders. Methods: A standard guidelines development process was followed. Relevant l iterature was identified using a computerized Medline search supplemented b y review of bibliographies. Operational criteria were used to rate the qual ity of scientific evidence, and the line of treatment recommendations inclu ded consensus clinical opinion. This section, on Axis I, and Axis II, and A xis III comorbidity, is 1 of 7 articles that were drafted and reviewed by c linicians. Revised drafts underwent national and international expert peer review. Results: Comorbid depression on Axis I is particularly prevalent in patient s with anxiety disorders, substance and use disorders, and eating disorders , but it also occurs in patients with schizophrenia, attention-deficit hype ractivity disorder (ADHD), and dementia. Depressive comorbidity has implica tions for assessment, management, and outcome. The relation between depress ion and personality disorders is complex. Patients with this comorbidity of ten require longer, more intense, and multimodal therapies. Depression is a lso prevalent in medical illnesses, requires careful diagnosis, and respond s to standard antidepressant treatments. Conclusions: Comorbidity can influence the course and outcome of both assoc iated conditions. Depression-specific psychotherapy and/or pharmacotherapy should be considered with comorbid depression is diagnosed.