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National Collaborating Centre for Mental Health (UK). Depression: The Treatment and Management of Depression in Adults (Updated Edition). Leicester (UK): British Psychological Society; 2010. (NICE Clinical Guidelines, No. 90.)

APPENDIX 16CLINICAL EVIDENCE PROFILES

This appendix contains evidence profiles for reviews substantially updated or added to the guideline update (summary evidence profiles are included in the evidence chapters). The use of evidence profiles was introduced since the previous guideline was published.

Evidence profile tables summarise both the quality of the evidence and the results of the evidence synthesis. Each table includes details about the quality assessment of each outcome: quality of the included studies, number of studies and participants, limitations, information about the consistency of the evidence (based on heterogeneity – see Chapter 3), directness of the evidence (that is, how closely the outcome measures, interventions and participants match those of interest) and any other considerations (for example, effect sizes with wide confidence intervals [CIs] would be described as imprecise data). Each evidence profile also includes a summary of the findings: number of patients included in each group, an estimate of the magnitude of effect, quality of the evidence, and the importance of the evidence (where appropriate). The quality of the evidence was based on the quality assessment components (study design, limitations to study quality, consistency, directness and any other considerations) and graded using the following definitions:

High = further research is very unlikely to change our confidence in the estimate of the effects

Moderate = further research is likely to have an important impact on our confidence in the estimate of the effect and may change the estimate

Low = further research is very likely to have an important impact on our confidence in the estimate of the effect and is likely to change the estimate

Very low = any estimate of effect is very uncertain.

For further information about the process and the rationale of producing an evidence profile table see GRADE (2004) Grading quality of evidence and strength of recommendations. British Medical Journal, 328, 1490–1497.

Appendix 16b. Clinical evidence profiles for psychological and psychological interventions

LOW-INTENSITY INTERVENTIONS

HIGH-INTENSITY INTERVENTIONS

Cognitive behavioural therapies

Is CBT effective compared with waitlist control?

Is CBT effective compared with placebo?

Is CBT effective compared with non-directive psychotherapies?

Is CBT (primary care) effective compared with GP care?

Is CBT effective compared with antidepressants?

Is CBT + antidepressants effective compared with antidepressants?

Is CBT + antidepressants effective compared with CBT?

Is CBT (for insomnia) + antidepressants effective compared with non-directive interventions (quasi-desens for insomnia) + antidepressants?

Is CBT effective compared with treatment as usual (TAU)/antidepressants in older adults?

Is CBT + antidepressants effective compared with antidepressants in older adults?

Is group CBT + antidepressants effective compared with antidepressants in older adults?

Is CBT effective compared with placebo + clinical management in relapse prevention?

Is CBT effective compared with antidepressants in relapse prevention?

Is CBT + antidepressants effective compared with antidepressants in relapse prevention?

Is CBT effective compared with behavioural activation?

Is CBT effective compared with IPT?

Is CBT effective compared with rational emotive behaviour therapy (REBT)?

Is CBT effective compared with integrative CBT

Is group CBT effective compared with other group therapies?

Is group CBT – mindfulness + GP care effective compared with GP care?

Is group CBT – mindfulness effective compared with waitlist control?

Is group CBT – mindfulness effective compared with antidepressants in relapse prevention?

Interpersonal therapy (IPT)

Is IPT effective compared with placebo?

Is IPT effective compared with usual care (including antidepressants)?

Is IPT (with/without placebo) effective compared with IPT + antidepressants in older adults?

Is IPT + antidepressants effective compared with antidepressants?

Is IPT (with/without placebo) effective compared with antidepressants (with/without clinical management)?

Is IPT (continuation treatment) effective compared with antidepressants?

Is IPT (continuation treatment) effective compared with treatment as usual (TAU)?

Is IPT (continuation treatment) + antidepressants effective compared with antidepressants?

Is IPT (continuation treatment) + antidepressants effective compared with antidepressants + medication clinic?

Is IPT (continuation treatment) + antidepressants effective compared with IPT + placebo?

Is IPT (continuation treatment) + placebo effective compared with placebo + medication clinic?

Is IPT (3-year maintenance treatment) effective compared with IPT + antidepressants?

Is IPT (3-year maintenance treatment) effective compared with IPT + placebo?

Is IPT (3-year maintenance treatment) effective compared with antidepressants?

Is IPT (3-year maintenance treatment) effective compared with placebo?

Is IPT (3-year maintenance treatment) + antidepressants effective compared with antidepressants?

Is IPT (3-year maintenance treatment) + antidepressants effective compared with medication clinic + antidepressants?

Is IPT (3-year maintenance treatment) + placebo effective compared with medication clinic + placebo?

Is IPT (3-year maintenance treatment) effective compared with IPT + placebo?

Is IPT (3-year maintenance treatment) + antidepressants effective compared with medication clinic + antidepressants?

Is IPT (with/without placebo) effective in IPT + antidepressants?

Is IPT + antidepressants effective compared with antidepressants in older adults?

Is IPT (with/without placebo) effective compared with antidepressants (with/without clinical management) in older adults?

Is IPT effective compared with standard care (Netherlands) in older adults?

Is IPT (2 to 3-year maintenance treatment) + antidepressants effective compared with IPT + placebo in older adults?

Is IPT (2 to 3-year maintenance treatment) + antidepressants effective compared with medication clinic + placebo in older adults?

Is IPT (2 to 3-year maintenance treatment) + placebo effective compared with medication clinic + placebo in older adults?

Is IPT (2 to 3-year maintenance treatment) + antidepressants effective compared with antidepressants in older adults?

Is IPT (2 to 3-year maintenance treatment) + antidepressant effective compared with medication clinic + antidepressants in older adults?

Appendix 16c. Clinical evidence profiles for pharmacological and physical interventions

Electroconvulsive therapy (ECT)

Is ECT effective in severe depression?

Copyright © The British Psychological Society & The Royal College of Psychiatrists, 2010.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Enquiries in this regard should be directed to the British Psychological Society.

Cover of Depression
Depression: The Treatment and Management of Depression in Adults (Updated Edition).
NICE Clinical Guidelines, No. 90.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2010.

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