A new study, published in Translational Behavioral Medicine, reveals that the majority of clinical practice guidelines for the treatment of major depression do not incorporate a stepped care approach and often fail to include physical activity or exercise as a recommended intervention. There is some concern that the variability in guidelines may influence the ability of clinicians to provide adequate care for individuals diagnosed with subthreshold or mild to moderate depression.
“The question of whether evidence for physical activity has been incorporated in an evidence-based way into clinical practice guidelines is a critically important one as guidelines are seen as the gold-standard of evidence-based medicine,” Courtney Hess, a doctoral student in counseling psychology at UMass Boston and the lead author of the review, writes. “As such, they play a major role in decisions about what will (and will not) be covered by insurance companies and government programs, and they have profound consequences for patient care.”
In 2016, the US Preventive Services Task Force recommended a universal depression screening protocol for primary care patients older than 13, with the goal of increasing detection and treatment access. This push has several flaws, including the high rate of false positives on measures such as the PHQ9, which has shown an association with depression diagnosis and antidepressant prescription in patients who do not meet the criteria for major depression. Moreover, antidepressants have been shown to be an ineffective treatment for mild depression, though they are often the primary form of treatment following an MDD diagnosis.
[For more on this story by Gavin Crowell-Williamson, go to https://www.madinamerica.com/2...idence-for-exercise/]
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