Clinical guidelines for the management of depression with specific comorbid psychiatric conditions French recommendations from experts (the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental).

D Bennabi, A Yrondi, T Charpeaud, J-B Genty, S Destouches, S Lancrenon, N Allaili, F Bellivier, T Bougerol, V Camus, O Doumy, J-M Dorey, F Haesebaert, J Holtzmann, C Lançon, M Lefebvre, F Moliere, I Nieto, C Rabu, R Richieri, L Schmitt, F Stephan, G Vaiva, M Walter, M Leboyer, W El-Hage, B Aouizerate, E Haffen, P-M Llorca, P Courtet

Journal: BMC psychiatry 2019;19(1):50

PMID: 30700272

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Abstract

BACKGROUND

Recommendations for pharmacological treatments of major depression with specific comorbid psychiatric conditions are lacking.

METHOD

The French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of depression based on the RAND/UCLA Appropriatneness Method. Recommendations for lines of treatment are provided by the scientific committee after data analysis and interpretation of the results of a survey of 36 psychiatrist experts in the field of major depression and its treatments.

RESULTS

The expert guidelines combine scientific evidence and expert clinician's opinion to produce recommendations for major depression with comorbid anxiety disorders, personality disorders or substance use disorders and in geriatric depression.

CONCLUSION

These guidelines provide direction addressing common clinical dilemmas that arise in the pharmacologic treatment of major depression with comorbid psychiatric conditions.

Address: Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, 25030, Besançon, France. [email protected].; Service de Psychiatrie et de Psychologie Médicale de l'adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.; Service de Psychiatrie de l'adulte B, Centre Expert Dépression Résistante FondaMental, CHU de Clermont-Ferrand, Clermont-Ferrand, France.; SYLIA-STAT, 10, boulevard du Maréchal-Joffre, 92340, Bourg-la-Reine, France.; Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France.; Service de Psychiatrie de l'adulte, CS 10217, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, Hôpital Nord, Grenoble, France.; Clinique Psychiatrique Universitaire, Centre Expert Dépression Résistante FondaMental, CHRU de Tours, Université de Tours, Inserm U1253 imaging and Brain: iBrain, Tours, France.; Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, UMR INRA 1286, NutriNeuro, Université de Bordeaux, Bordeaux, France.; Old Age Psychiatry Unit, pôle EST, Centre Hospitalier le Vinatier, Bron, France.; Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France.; Geriatrics Unit, CM2R, Hospices civils de Lyon, Hôpital des Charpennes, Villeurbanne, France.; Service universitaire des pathologies psychiatriques résistantes, Centre expert FondaMental, PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Centre Hospitalier Le Vinatier, University Lyon 1, Bron, France.; Pôle Psychiatrie, Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France.; Département des Urgences et Post-Urgences Psychiatriques, Centre Expert Dépression Résistante FondaMental, CHU Montpellier, Univ Montpellier, Montpellier, France.; DHU PePSY, Pole de psychiatrie et d'addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.; Service hospitalo-universitaire de psychiatrie d'adultes et de psychiatrie de liaison - secteur 1, Centre Expert Dépression Résistante Fondamental, CHRU Brest, hôpital de Bohars, Bohars, France.; Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, CHU de Lille, Hôpital Fontan 1, Lille, France.; Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, 25030, Besançon, France.

DOI: 10.1186/s12888-019-2025-7

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MeSH Terms: Aged, Anxiety Disorders, Biological Psychiatry, Comorbidity, Depressive Disorder, Major, Expert Testimony, Female, Foundations, France, Humans, Male, Personality Disorders, Practice Guidelines as Topic, Psychiatry, Psychopharmacology, Substance-Related Disorders