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Background
MDD is a serious public health problem in the Department of Defense (DoD), the Veteran Health Administration (VHA) health care systems and in the nation at large; hence, timely diagnosis and effective treatment
is an important responsibility of health care providers. About ten to fifteen percent of all primary care patients have MDD, easily making it perhaps the most common disorder that primary care providers see in their practices (Simon, 1999).
Research now shows that a range of cost-effective treatments is feasible and efficacious in both the primary care and specialty mental health care settings (Davidson, 1999). Effective treatment can reduce and/or eliminate depression symptoms (Mulrow, 1998),
improve health-related quality of life, (Heiligenstein, 1995), and, in some research, even improve occupational performance and productivity among those with MDD (Mintz, 1992). Other research has shown that guideline-driven improvements in the quality of depression
care can result in improved symptoms and symptom-related quality of life for those affected (Katon, 1995).
In 2000, the Veterans Administration (VA) and the Department of Defense (DoD) developed a clinical practice guideline designed to assist clinicians evaluate and manage adult patients with depression. In 2009 the guideline was updated:
VA/DoD Clinical Practice Guideline for Management of Major Depressive Disorder in Adults, May 09.
The MDD CPG is one of the supporting guidelines for the DoD/VA Clinical Practice Guideline for Post-Deployment Health Evaluation and Management (PDH-CPG), Dec 01, which was developed to assist primary care providers in evaluating and providing care for individuals with potentially deployment-related health concerns and conditions.
Table of Contents
Clinical Guidance
- Cognitive Behavioral Therapy for Depression in Veterans and Military Servicemembers: Therapist Manual, Department of Veterans Affairs, 2011
- American Psychiatric Association Practice Guideline for the Treatment of Patients with Major Depressive Disorder, 3rd edition, Oct 10
- Screening Adults for Depression in Primary Care: A Position Statement of the American College of Preventive Medicine, Journal of Family Practice, Vol 58, No 10, Oct 09
- VA/DoD Clinical Practice Guideline for Management of Major Depressive Disorder in Adults, May 09
- Institute for Clinical Systems Improvement (ICSI). Major depression in adults in primary care, May 08
- Michigan Quality Improvement Consortium. Management of adults with major depression. May 08
- DoD/VA Clinical Practice Guideline for Post-Deployment Health Evaluation and Management, Dec 01
- National Institute for Health and Clinical Excellence (NICE), Computerised Cognitive Behaviour Therapy for Depression and Anxiety, Feb 06
- Kaiser Permanente Care Management Institute Depression Clinical Practice Guidelines, Mar 06
- Screening for Depression in Primary Care: Recommendation Statement from the Canadian Task Force on Preventive Health Care, Jan 05
- DHCC Specialized Care Program
Implementation Guidelines
Implementation Tools
Other Related Information
Education and Training
- US Medicine Educational Supplement, Diagnosing and Managing Depression: Evidence-Based Care Strategies for the Federal Healthcare Professional, Sep 12 (1.0 AMA PRA Category 1 Credit™)
- DCoE MDD CPG Education Materials
- RESPECT-Mil (RESPECT-Mil, which stands for Re-Engineering Systems of Primary Care Treatment in the Military, is a system of primary care designed to enhance the recognition and high-quality management of Post-Traumatic Stress Disorder (PTSD) and depression. The US Army Medical Command has directed wide implementation of RESPECT-Mil in Army primary care facilities. Tri-service implementation is in the planning stages. Web-based training for the program is available at this Web site.)
- CME Institute, A Review of Current Guidelines for Depression Treatment, Apr 10 (Provides 1 free CME credit.)
- Deployment Health Clinical Training Series Module, Managing Depression in Primary Care Using the VA/DoD Major Depressive Disorder Clinical Practice Guideline, 7 May 07
- National Quality Management Program (NQMP) On-Line Education Depression Detection and Management in the Direct Care System (DCS) 2004, 30 Nov 05 (An overview of depression and the findings of the 2004 NQMP Depression Detection and Management quality study.)
- Review of the VHA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder in Adults 2002, DHCC PowerPoint Presentation
Research
- Agency for Healthcare Research and Quality (AHRQ) Study, Comparative Effectiveness of Second- Generation Antidepressants in the Pharmacologic Treatment of Adult Depression, Jan 07
- National Quality Management Program (NQMP), Depression Detection in the Direct Care System Special Study Fact Sheet, 2004
- National Quality Management Program (NQMP), Acute Phase Management of Newly Diagnosed Depression in the Military Health System Special Study Fact Sheet, 2004
- National Quality Management Program (NQMP), Depression Comorbidity in the Military Health System Special Study Fact Sheet, 2004
- National Quality Management Program (NQMP), Depressive Disorder Treatment in the Military Health System (MHS) Special Study Fact Sheet, Revised May 03
Related Links
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