Role of antidepressants and benzodiazepines
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DEP 1. Antidepressants should not be considered for the initial treatment of adults with mild depressive episode. Tricyclic antidepressants (TCA) or fluoxetine should be considered in adults with moderate to severe depressive episode/disorder.OTH 2. Neither antidepressants nor benzodiazepines should be used for the initial treatment of individuals with complaints of depressive symptoms in absence of current/prior depressive episode/disorder. |
Duration of antidepressant treatment
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DEP 2. Antidepressant treatment should not be stopped before 9–12 months after recovery. |
Brief, structured, psychological treatment
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DEP 3. Interpersonal therapy and cognitive behavioural therapy (CBT) (including behavioural activation, DEP 4), and problem-solving treatment should be considered as psychological treatment of depressive episode/disorder in non-specialized health care settings if there are sufficient human resources (e.g., supervised community health workers). In moderate and severe depression, problem-solving treatment should be considered as adjunct treatment.OTH 3. A problem-solving approach should be considered in people with depressive symptoms (in the absence of depressive episode/disorder) who are in distress or have some degree of impaired functioning.OTH 1. Psychological treatment based on CBT principles should be considered in repeat adult help seekers with medically unexplained somatic complaints who are in substantial distress and who do not meet criteria for depressive episode/disorder. |
Relaxation training and physical activity
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DEP 5, DEP 6. Relaxation training and advice on physical activity may be considered as treatment of adults with depressive episode/disorder. In moderate and severe depression, these interventions should be considered as adjunct treatment. |
Psychological support after recent traumatic event
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OTH 4. Psychological debriefing should not be used for recent traumatic event to reduce the risk of post-traumatic stress, anxiety, or depressive symptoms.OTH 5. Providing access to support based on the principles of psychological first aid should be considered for people in acute distress exposed recently to a traumatic event. |
Graded self-exposure based on CBT principles in adults with post-traumatic stress disorder (PTSD) symptoms
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OTH 6. If it is possible to continue to follow up with the patient, graded self-exposure based on the principles of CBT should be considered in adults with PTSD symptoms. |
Psychological treatment based on CBT principles in people concerned about prior panic attacks
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OTH7. Psychological treatment based on CBT principles should be considered as treatment of people concerned about prior panic attacks. |