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Social Anxiety Disorder: Recognition, Assessment and Treatment

Social anxiety disorder is very common and often coexists with other mental health problems. It can be severely detrimental to quality of life, with far-reaching consequences for education, employment and relationships. Only a minority of people with social anxiety disorder receive help, but this guideline demonstrates that effective treatments exist and it aims to increase identification and assessment so that people can access interventions to help them overcome this disabling condition.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2013
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Benzodiazepines in Older Adults: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet]

The use of benzodiazepines has been associated with several adverse effects including, ataxia, dizziness, over-sedation, anterograde amnesia, and dependence. The severity of adverse effects, particularly those associated with the central nervous system, may be greater in older adults. Therefore, close monitoring is typically recommended when benzodiazepines are used by older adults. In addition, several reviews and guidelines recommend that the use of long-acting benzodiazepines by older adults be avoided. High utilization by older adults and documented safety concerns indicate that a review of the evidence on the use of benzodiazepines by older adults is warranted.

Rapid Response Report: Peer-Reviewed Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 2011
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Drug Misuse: Opioid Detoxification

The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2008
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Type 1 Diabetes in Adults: Diagnosis and Management

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015
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Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance: Updated edition

The guideline makes recommendations for the use of pharmacological, psychological and service-level interventions. It aims to:

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: December 2014
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Self-Harm: Longer-Term Management

This is the first NICE guideline on the longer-term management of both single and recurrent episodes of self-harm.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Clinical effectiveness of interventions for treatment-resistant anxiety in older people: a systematic review

The aim of the study was to evaluate the clinical effectiveness of pharmacological, psychological and alternative therapies for treatment-resistant anxiety in older people by undertaking a systematic review of randomised controlled trials and prospective comparative observational studies. However, no study was identified that evaluated interventions in treatment-resistant older adults with anxiety disorders and, therefore, there is uncertainty as to which treatments are clinically effective in these patients.

Health Technology Assessment - NIHR Journals Library.

Version: August 2014
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Depression: The Treatment and Management of Depression in Adults (Updated Edition)

This clinical guideline on depression is an updated edition of the previous guidance (published in 2004). It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage depression in adults.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2010
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Drug Class Review: Antiepileptic Drugs for Indications Other Than Epilepsy: Final Report Update 2 [Internet]

Antiepileptic drugs have been used beyond treatment of seizure disorders since the 1960s. As new antiepileptic drugs have become available, there has been interest in how they compare with older therapies (carbamazepine, phenytoin, and valproate) and each other in disorders where conventional pharmacotherapy has typically been suboptimal and limited by drug-related toxicity. The objective of this report is to evaluate the comparative effectiveness and harms of antiepileptic drugs used for bipolar disorder, fibromyalgia, migraine prophylaxis, and chronic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
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Discontinuation Strategies for Patients with Long-term Benzodiazepine Use: A Review of Clinical Evidence and Guidelines [Internet]

This review aims to summarize current evidence-based discontinuation strategies and clinical guidelines for long-term adult benzodiazepines (BZD) users to validate policy changes and promote best practices amongst clinicians.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: July 29, 2015
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Screening in Primary Care Settings for Illicit Drug Use: Staged Systematic Review for the United States Preventive Services Task Force [Internet]

Illicit drug use and abuse are serious problems among adolescents, adults, and pregnant women in the United States, and approximately 3.2% of the population age 12 and over meet criteria for a drug use disorder. Many individuals with drug use disorders have co-existing mental and physical health conditions.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: January 2008
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Drug Class Review: Newer Drugs for Insomnia: Final Report Update 2 [Internet]

Insomnia is a serious health problem that affects millions of people. Population surveys have estimated the prevalence of insomnia to be about 30% to 50% of the general population. About three-fourths of people who have trouble sleeping say that the problem is "occasional," averaging about 6 nights per month, with one-fourth having frequent or chronic insomnia, averaging about 16 nights per month. Individuals with insomnia most often report a combination of difficulty falling asleep and intermittent wakefulness during sleep. Treatment of insomnia involves behavioral changes, such as minimizing habits that interfere with sleep (for example, drinking coffee or engaging in stressful activities in the evening), and pharmacotherapy with sedating antidepressants (for example, trazodone), sedating antihistamines, anticholinergics, benzodiazepines, or nonbenzodiazepine hypnotics. The benzodiazepines and the newer sedative hypnotics zolpidem, zaleplon, zopiclone, and eszopiclone work through gamma-aminobutyric acid receptors. Ramelteon, a hypnotic approved by the United States Food and Drug Administration (FDA) in July 2005, is a selective melatonin receptor (MT1 and MT2) agonist. New nonbenzodiazepine drugs have been sought for multiple reasons, including reduction of the risk of tolerance, dependence, and abuse associated with benzodiazepines. The purpose of this review is to evaluate the comparative evidence on benefits and harms of these medications in people with insomnia to help policymakers and clinicians make informed choices about the use of newer drugs for insomnia.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
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Depression (PDQ®): Health Professional Version

Expert-reviewed information summary about the diagnosis, assessment, and treatment of depression in adults and children who have cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 2, 2017

A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive–compulsive disorder in children/adolescents and adults

The study found that in adults with obsessive–compulsive disorder (OCD), psychological interventions, clomipramine, selective serotonin reuptake inhibitors (SSRIs) or combinations of these are all effective, whereas in children and adolescents with OCD, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective.

Health Technology Assessment - NIHR Journals Library.

Version: June 2016
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Management of Insomnia Disorder [Internet]

To assess the efficacy, comparative effectiveness, and harms of treatments for insomnia disorder in the general adult population and older adults.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: December 2015
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A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia

The study found that supervised person-centred care, communication skills and dementia-care mapping, as well as sensory therapy activities and structured music therapies, reduce agitation in care-home dementia residents. Health and social care costs were between £7000 and £15,000 depending on the severity of agitation. Further work is required to investigate interventions for agitation for use with people with dementia living in their own homes.

Health Technology Assessment - NIHR Journals Library.

Version: June 2014
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Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders

This guideline has been developed to advise on the identification, treatment and management of the eating disorders anorexia nervosa, bulimia nervosa and related conditions. The guideline recommendations have been developed by a multidisciplinary group of health care professionals, patients and their representatives, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with eating disorders while also emphasising the importance of the experience of care for patients and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2004
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Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence

This clinical guideline on alcohol-use disorders was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out the evidence for the treatment and management of harmful drinking and alcohol dependence in adults and in young people aged 10 to 17 years.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2011
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Borderline Personality Disorder: Treatment and Management

The guideline on Borderline Personality Disorder, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage borderline personality disorder.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2009
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Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]

Depression causes significant suffering and is commonly seen in primary care. Because primary care providers sometimes fail to identify patients as depressed, systematic screening programs in primary care may be of use in improving outcomes in depressed patients. Depression screening is predicated on the notion that identification will allow effective treatments to be delivered and that the benefits of treatment will outweigh the harms. Treatment efficacy of antidepressants and psychotherapy in general adult populations was established in a previous United States Preventive Services Task Force (USPSFT) review on depression screening, but treatment in older adults was not examined specifically. Additionally, harms of screening and treatment were not previously examined in detail.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: December 2009
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