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临床实践指南:单相抑郁症的诊断与治疗——国家疾病管理指南。

Clinical Practice Guideline: The Diagnosis and Treatment of Unipolar Depression—National Disease Management Guideline.

机构信息

Department of Medical Psychology, University Hospital Hamburg-Eppendorf and Agency for Quality in Medicine (AZQ), Berlin.

出版信息

Dtsch Arztebl Int. 2023 May 19;120(20):355-361. doi: 10.3238/arztebl.m2023.0074.

Abstract

BACKGROUND

Depression is one of the most common mental disorders worldwide. The German National Disease Management Guideline on Unipolar Depression (NDGM), (Nationale Versorgungsleitlinie, NVL), updated in 2022, contains recommendations on the diagnosis and treatment of acute and chronic depressive disorders.

METHODS

The update was based on the findings of a systematic review of the evidence (2013-2022) and was issued by a multidisciplinary panel after a formalized consensus process.

RESULTS

The structure of the guideline was fundamentally revised and is now based on the phases of depression and/or its treatment, as well as on the severity of the disease. There is newly added material with recommendations on Internet- and mobile-device based treatments, esketamine, repetitive magnetic stimulation, psychosocial therapies, rehabilitation, social participation, and complex forms of care. The guideline also emphasizes better coordination of all services in the care of patients with depression. This article covers the most important changes and additions among the 156 recommendations in the guideline. More information and accompanying materials are available at www.leitlinien.de/depression.

CONCLUSION

There are effective treatments for depression and a variety of supportive measures that can be applied with great benefit by primary care physicians, psychiatrists, psychotherapists, and complementary care providers. The updated guideline aims to further improve the early detection, definitive diagnosis, treatment, and interdisciplinary care of people with depression.

摘要

背景

抑郁症是全球最常见的精神障碍之一。德国单相抑郁症国家管理指南(NDGM)于 2022 年更新,其中包含了对急性和慢性抑郁症的诊断和治疗建议。

方法

本次更新基于对 2013 年至 2022 年证据的系统评价,并在经过正式的共识程序后由多学科小组发布。

结果

指南的结构进行了根本性的修订,现在基于抑郁症的阶段和/或其治疗,以及疾病的严重程度。新增了关于基于互联网和移动设备的治疗、依他佐辛、重复经颅磁刺激、心理社会治疗、康复、社会参与和复杂形式护理的建议。该指南还强调了在抑郁症患者护理中更好地协调所有服务。本文涵盖了指南中 156 条建议中最重要的变化和补充。更多信息和配套材料可在 www.leitlinien.de/depression 上获得。

结论

抑郁症有有效的治疗方法和多种支持性措施,初级保健医生、精神科医生、心理治疗师和补充护理提供者都可以从中获益。更新后的指南旨在进一步改善抑郁症患者的早期发现、明确诊断、治疗和跨学科护理。

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