CANMAT depression therapy

Question 1

1st Line therapy for acute

MDD

Answer 1

CBT

IPT

Question 2

2nd Line therapy for acute MDD

Answer 2

Telephone CBT
Computer delivered CBT
Bibliotherapy
Behavioural activation
CBASP

Question 3

3rd Line therapy for acute MDD

Answer 3

Psychodynamic
ACT
MI
Emotion focused therapy

Question 4

1st Line therapy for maintenance

MDD

Answer 4

CBT

Question 5

2nd Line therapy for maintenance

MDD

Answer 5

IPT
MBCT
CBASP
Behavioural activation

Question 6

3rd Line therapy for maintenance

MDD

Answer 6

none with evidence

Question 7

What is the recommendation level (which line) of CBT for: acute, maintenance and combination therapy?

Answer 7

1st, 1st, 2nd

Question 8

What is the recommendation level (which line) of IPT for: acute, maintenance and combination therapy?

Answer 8

1st, 2nd, 2nd

Question 9

What is the recommendation level (which line) of psychodynamic Tx for: acute, maintenance and combination therapy?

Answer 9

3rd, lack of evidence, lack of evidence

Question 10

What is the recommendation level (which line) of behavioural activation for: acute, maintenance and combination therapy?

Answer 10

2nd, 2nd, lack of evidence

CBASP is also 2nd, 2nd

Question 11

What can you say about concurrent combined Tx for MDD ?

Answer 11

Combined better than either meds or therapy alone (IPT, CBT)
Especially true for women and elderly
remains 2nd line due to practical concerns and cost
consider combining with bibliotherapy or computer assisted therapy
Also: in adolescents: like anxiety: best results when they are combined.

Question 12

What can you say about sequential Tx for MDD (meds then therapy) ?

Answer 12

Level 2 evidence for adding CBT or IPT to partial responders to meds in acute phase
Level 2 evidence to cross over to therapy when DC pharmacotherapy after stabilization as an alternative to continuing pharmacotherapy.
maintenance therapy= maintenance meds> better than DC meds