The Canadian Network for Mood and Anxiety Treatments (CANMAT) has released updated clinical guidelines for managing major depression, which are considered the most widely used guidelines for depression in the world. The new guidelines integrate the latest scientific evidence and advances in depression care since the previous version was published in 2016. Led by researchers at the University of B.C. and the University of Toronto, the update involved a national working group of over 40 academic clinical experts and patient partners. The goal of the update is to empower clinicians with the latest recommendations to improve outcomes and quality of life for the millions of people affected by depression.
Depression is a significant public health burden in Canada, with more than one in 10 Canadians experiencing depression at some point in their lives. However, only 20 percent of people receive adequate treatment. The updated guidelines cover eight primary topic areas that map the patient care journey, from assessment and diagnosis to the selection of treatments and strategies to prevent recurrence. The guidelines are designed in a question-and-answer format to be practical, accessible, and easy for clinicians to use. They also emphasize the importance of collaboration with patients in care decisions to provide a personalized treatment approach that considers an individual’s needs, preferences, and treatment history.
The guidelines highlight the strong evidence base for well-established first-line treatments, including various medications and psychological treatments such as cognitive behavioural therapy, interpersonal therapy, and behavioural activation. New psychological and pharmacological treatments have been added based on recent evidence. The guidelines also emphasize patient participation in choosing treatment, applying outcome measures throughout care, and utilizing digital mental health tools in the management of depression. Lifestyle interventions such as exercise, nutrition, and sleep hygiene are also explored, as well as when neuromodulation treatments should be considered for patients who do not respond to initial treatments or develop treatment-resistant depression.
The guidelines provide further direction on how healthcare professionals can incorporate lifestyle interventions, including exercise, nutrition, and sleep hygiene. They also address when neuromodulation treatments should be considered and what to do if a patient does not respond to initial treatments or develops treatment-resistant depression. The guidelines emphasize the importance of collaborative decision-making between healthcare professionals and patients and highlight the need for personalized treatment approaches that consider individual needs, preferences, and treatment history. The guidelines also acknowledge the complexity and individualized nature of depression and provide guidance on how healthcare professionals can choose the right treatment option based on the level of evidence supporting each therapy and factors such as safety, tolerability, and feasibility.
The CANMAT guidelines emphasize the importance of patient participation in choosing treatment, applying outcome measures throughout care, and utilizing digital mental health tools in the management of depression. They also cover the incorporation of lifestyle interventions such as exercise, nutrition, and sleep hygiene, as well as when neuromodulation treatments should be considered and how to address treatment-resistant depression. The guidelines aim to provide clinicians with the latest recommendations to improve outcomes and quality of life for individuals affected by depression. CANMAT is a network of academic and clinical experts dedicated to improving clinical care for people with mood and anxiety disorders, and the new depression guidelines were published 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 released.
