Role of CBT and NICE and CANMAT guidelines for the treatment of depression in adults

Abstract

This paper outlines the indications of good clinical practice for the treatment of depression on the basis of the latest update of the guidelines of the National Institute for Health and Care Excellence (NICE) and of the Canadian Network for Mood and Anxiety Treatments (CANMAT), documents that are a benchmark worldwide. Therefore, they will be used to draw indications for the Italian context. We will focus on the role played by cognitive-behavioural therapy (CBT), in its various forms, in the treatment of depression at different levels of severity, compared to other treatments and in different phases of treatment. We will define depression, its different levels of severity, and the various forms of CBT considered. We will then describe the methods used to select a particular intervention, not necessarily psychological, depending on the severity of depression or other factors such as cost-benefit to the health system or patient preference. Below we will describe the scientific data on the effectiveness of cognitivebehavioural interventions compared with others, and recommendations for each level of severity or phase of treatment. We will conclude that the effectiveness of CBT for depression is well established and is often one of the first interventions suggested for this framework. The milder the framework, the more CBT is recommended; the more the framework worsens, or it is in the acute phase, the more it is suggested to be combined with other treatments. Finally, we will reflect on ideas for adapting methods and procedures to the Italian context.