Best treatment for mild or moderate depression unclear

Guidelines for the management of mild or moderate depression are unclear because firm evidence is lacking, claim doctors
in this week's BMJ.


The (UK) National Institute for Clinical Excellence (NICE) provides clear guidance on the treatment of moderate to severe
depression, but what is less clear is the appropriate treatment for mild to moderate depression, write Gene Feder and
colleagues.


They say that the study on which the guidelines are based identifies evidence supporting problem solving therapies and
counselling, but evidence on other interventions is weak or absent.


Although these shortcomings are acknowledged, the guidelines offer limited advice on how to determine whether or not a
particular patient may benefit from treatment, they add.


They suggest that we need a better understanding of the interaction that occurs when individuals seek medical help for an
emotional problem. "This medicalisation of unhappiness would benefit from sociological as well as clinical research," they
conclude.


(Editorial: NICE guidelines for the management of depression)

bmj/cgi/content/full/330/7486/267


Contact:

Gene Feder, Professor of Primary Care Research and Development, Barts and the London, Queen Mary's School of Medicine and
Dentistry, London, UK

Email: g.s.federqmul.ac.uk