What do general medical guidelines say about depression care? Depression treatment recommendations in general medical...

Depression is one of the most costly and prevalent mental disorders, and it often co-occurs in patients with general medical conditions. This review identifies the extent to which depression treatment is being addressed in guidelines for general medical illness treatment.

We conducted a review of the literature published within the past year pertaining to depression treatment guidelines in medical care. We also conducted a systematic review of available practice guidelines listed by the Agency for Research and Quality to assess the extent to which depression treatment is being addressed in current general medical treatment guidelines. Overall, only a handful of articles addressed treatment of depression within the context of general medical care, and most only addressed screening. Among 199 available practice guidelines for general medical conditions, only 83 mentioned depression treatment, and the majority of these only addressed depression screening.

To improve outcomes in patients with co-occurring general medical conditions, general medical guidelines should include specific recommendations for treating and co-managing depression. Additional strategies that facilitate the translation of guidelines into routine practice, address the management of multiple chronic illnesses, and reduce the stigma of mental illness are also needed.