Clinical guidelines for depressive disorders. Summary of recommendations relevant to family physicians.
Major depressive disorder (MDD) is an illness of great importance in public health. In primary care practices, patients with major depression have greater levels of disability than those with other chronic conditions, such as diabetes, arthritis, chronic back pain, or hypertension. According to the World Health Organization, by 2020 depression will cause more disability than infectious diseases, cancer, or accidents and will be second only to ischemic heart disease as a cause of disability. In the summer of 2001, a working group of the Canadian Network for Mood and Anxiety Treatments (CANMAT) partnered with the Canadian Psychiatric Association to publish Clinical Guidelines for the Treatment of Depressive Disorders. The full text of the guidelines, with references, is available on both websites: www.canmat.org and www.cpa-apc.org. Most of the recommendations were based on level I (meta-analysis or replicated randomized controlled trials) or level II evidence (at least one randomized controlled trial). Statements made in this summary are based on the guidelines and are not specifically referenced. We summarize the recommendations relevant to family physicians.