A treatment outline for depressive disorders. The Quality Assurance Project

Abstract

With College and Government support the Quality Assurance Project is developing a series of explicit and detailed treatment outlines of major psychiatric disorders for use in peer review. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists and the views of a panel of nominated experts. The present outline concerns the treatment of depressive disorders. The three sources of information were in agreement that tricyclic and allied antidepressants were the treatments of choice for endogenous depression and were also to be considered in persistent neurotic depressions. Electroconvulsive therapy was recommended in patients with endogenous depression who were severely ill, troubled by hallucinations and delusions or for whom the antidepressant drugs had not proven effective. The psychotherapies, both dynamic and behavioural, were regarded as the treatments of choice in neurotic depression.