Psychiatrists and mental health professionals now have a fresh standard for addressing major depression, courtesy of newly updated clinical guidelines released by the Canadian Network for Mood and Anxiety Treatments (CANMAT).

These guidelines from CANMAT hold the status of being the most globally utilized clinical directives for managing depression. The latest iteration incorporates the most recent scientific findings and advancements in depression care since the previous guidelines were issued in 2016. Spearheaded by researchers from the University of British Columbia and the University of Toronto, alongside a national working group comprising over 40 academic clinical experts and patient collaborators, this update signifies a comprehensive effort.

Dr. Raymond Lam, co-lead author and psychiatry professor at UBC, highlights that these recommendations not only reflect the evidence and consensus among top experts in depression research and care but also incorporate the perspectives of individuals who have lived through depression. The aspiration behind this update is to equip clinicians with the latest insights to enhance outcomes and elevate the quality of life for the millions affected by depression.

Depression affects over one in 10 Canadians at some point in their lives, presenting a significant public health challenge. Despite this, only a fraction of those affected receive adequate treatment.

The refreshed guidelines delineate eight primary areas spanning the patient care continuum, from initial assessment and diagnosis to treatment selection and strategies for preventing relapse. Presented in a question-and-answer format, the guidelines aim for practicality, accessibility, and ease of use for clinicians.

The development of these updated guidelines involved an exhaustive review of recent scientific literature since the prior guidelines of 2016. Drafts underwent refinement through input from patient collaborators, expert peer review, and a structured consensus process.

The resulting recommendations are organized based on the level of evidence supporting each therapy and considerations such as safety, tolerability, and practicality. The guidelines emphasize collaborative decision-making, empowering healthcare professionals to tailor treatment approaches to individual needs, preferences, and treatment histories.

Dr. Lam stresses the importance of patient involvement in care decisions and the adoption of personalized treatment approaches. Established first-line treatments, including various medications and psychological therapies like cognitive-behavioral therapy, interpersonal therapy, and behavioral activation, retain a strong evidence base in the guidelines. Additionally, new psychological and pharmacological treatments have been included based on recent evidence.

Dr. Sidney Kennedy, co-lead author and psychiatry professor at the University of Toronto, notes notable additions to the guidelines, including a focus on patient involvement in treatment selection, the integration of outcome measures throughout care, and an exploration of digital mental health tools. Lifestyle interventions such as exercise, nutrition, and sleep hygiene are also addressed, alongside considerations for neuromodulation treatments and strategies for treatment-resistant depression.

Dr. Lena Quilty, a co-author and psychiatry associate professor at the University of Toronto, underscores the enhanced support for established interventions and the introduction of new approaches targeting depression and its associated challenges.

CANMAT, a network of experts devoted to improving clinical care for mood and anxiety disorders, published the new depression guidelines in The Canadian Journal of Psychiatry. Updated versions of the CANMAT Pocket Guide to Depression for clinicians and the CHOICE-D Patient and Family Guide to Depression Treatment will also be available.

Remember, if you need further guidance or support, don’t hesitate to reach out to your mental health professional or contact us for assistance.