Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental.


Journal

BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559

Informations de publication

Date de publication:
28 08 2019
Historique:
received: 08 08 2018
accepted: 12 08 2019
entrez: 29 8 2019
pubmed: 29 8 2019
medline: 29 4 2020
Statut: epublish

Résumé

Clear guidance for successive antidepressant pharmacological treatments for non-responders in major depression is not well established. Based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of treatment-resistant depression. The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for treatment-resistant depression. A written survey comprising 118 questions related to highly-detailed clinical presentations was completed on a risk-benefit scale ranging from 0 to 9 by 36 psychiatrist experts in the field of major depression and its treatments. Key-recommendations are provided by the scientific committee after data analysis and interpretation of the results of the survey. The scope of these guidelines encompasses the assessment of pharmacological resistance and situations at risk of resistance, as well as the pharmacological and psychological strategies in major depression. The expert consensus guidelines will contribute to facilitate treatment decisions for clinicians involved in the daily assessment and management of treatment-resistant depression across a number of common and complex clinical situations.

Sections du résumé

BACKGROUND
Clear guidance for successive antidepressant pharmacological treatments for non-responders in major depression is not well established.
METHOD
Based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of treatment-resistant depression. The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for treatment-resistant depression. A written survey comprising 118 questions related to highly-detailed clinical presentations was completed on a risk-benefit scale ranging from 0 to 9 by 36 psychiatrist experts in the field of major depression and its treatments. Key-recommendations are provided by the scientific committee after data analysis and interpretation of the results of the survey.
RESULTS
The scope of these guidelines encompasses the assessment of pharmacological resistance and situations at risk of resistance, as well as the pharmacological and psychological strategies in major depression.
CONCLUSION
The expert consensus guidelines will contribute to facilitate treatment decisions for clinicians involved in the daily assessment and management of treatment-resistant depression across a number of common and complex clinical situations.

Identifiants

pubmed: 31455302
doi: 10.1186/s12888-019-2237-x
pii: 10.1186/s12888-019-2237-x
pmc: PMC6712810
doi:

Substances chimiques

Antidepressive Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

262

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Auteurs

D Bennabi (D)

Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France. djamila.bennabi@univ-fcomte.fr.
Department of Clinical Psychiatry, 25030 Besançon University Hospital, 25030, Besançon, France. djamila.bennabi@univ-fcomte.fr.

T Charpeaud (T)

Service de Psychiatrie de l'adulte B, Centre Expert Dépression Résistante FondaMental, CHU de Clermont-Ferrand, Clermont-Ferrand, France.

A Yrondi (A)

Service de Psychiatrie et de Psychologie Médicale de l'adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center Université de Toulouse, Inserm, UPS, Toulouse, France.

J-B Genty (JB)

SYLIA-STAT, 10, boulevard du Maréchal-Joffre, 92340, Bourg-la-Reine, France.

S Destouches (S)

SYLIA-STAT, 10, boulevard du Maréchal-Joffre, 92340, Bourg-la-Reine, France.

S Lancrenon (S)

SYLIA-STAT, 10, boulevard du Maréchal-Joffre, 92340, Bourg-la-Reine, France.

N Alaïli (N)

Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France.

F Bellivier (F)

Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France.

T Bougerol (T)

Service de Psychiatrie de l'adulte, CS 10217, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, Hôpital Nord, Grenoble, France.

V Camus (V)

Clinique Psychiatrique Universitaire, Centre Expert Dépression Résistante FondaMental, CHRU de Tours, Université de Tours, Inserm U1253 imaging and Brain : iBrain, Tours, France.

J-M Dorey (JM)

Old Age Psychiatry Unit, pôle EST, Centre Hospitalier le Vinatier, Bron, France.
Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France.
Geriatrics Unit, CM2R, Hospices civils de Lyon, Hôpital des Charpennes, Villeurbanne, France.

O Doumy (O)

Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, UMR INRA 1286, NutriNeuro, Université de Bordeaux, Bordeaux, France.

F Haesebaert (F)

Service universitaire des pathologies psychiatriques résistantes, Centre expert FondaMental, PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Centre Hospitalier Le Vinatier, University Lyon 1, Bron, France.

J Holtzmann (J)

Service de Psychiatrie de l'adulte, CS 10217, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, Hôpital Nord, Grenoble, France.

C Lançon (C)

Pôle Psychiatrie, Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France.

M Lefebvre (M)

Service universitaire des pathologies psychiatriques résistantes, Centre expert FondaMental, PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Centre Hospitalier Le Vinatier, University Lyon 1, Bron, France.

F Moliere (F)

Département des Urgences et Post-Urgences Psychiatriques, Centre Expert Dépression Résistante FondaMental, CHU Montpellier, University of Montpellier, Montpellier, France.

I Nieto (I)

Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France.

C Rabu (C)

DHU PePSY, Pole de psychiatrie et d'addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.

R Richieri (R)

Pôle Psychiatrie, Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France.

L Schmitt (L)

Service de Psychiatrie et de Psychologie Médicale de l'adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center Université de Toulouse, Inserm, UPS, Toulouse, France.

F Stephan (F)

Service hospitalo-universitaire de psychiatrie d'adultes et de psychiatrie de liaison - secteur 1, Centre Expert Dépression Résistante Fondamental, CHRU Brest, hôpital de Bohars, Bohars, France.

G Vaiva (G)

Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, CHU de Lille, Hôpital Fontan 1, Lille, France.

M Walter (M)

Service hospitalo-universitaire de psychiatrie d'adultes et de psychiatrie de liaison - secteur 1, Centre Expert Dépression Résistante Fondamental, CHRU Brest, hôpital de Bohars, Bohars, France.

M Leboyer (M)

DHU PePSY, Pole de psychiatrie et d'addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.

W El-Hage (W)

Clinique Psychiatrique Universitaire, Centre Expert Dépression Résistante FondaMental, CHRU de Tours, Université de Tours, Inserm U1253 imaging and Brain : iBrain, Tours, France.

P-M Llorca (PM)

Service de Psychiatrie de l'adulte B, Centre Expert Dépression Résistante FondaMental, CHU de Clermont-Ferrand, Clermont-Ferrand, France.

P Courtet (P)

Département des Urgences et Post-Urgences Psychiatriques, Centre Expert Dépression Résistante FondaMental, CHU Montpellier, University of Montpellier, Montpellier, France.

B Aouizerate (B)

Old Age Psychiatry Unit, pôle EST, Centre Hospitalier le Vinatier, Bron, France.
Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France.
Geriatrics Unit, CM2R, Hospices civils de Lyon, Hôpital des Charpennes, Villeurbanne, France.

E Haffen (E)

Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France.

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