Guía de práctica clínica basada en evidencias para el tratamiento de depresión en adultos en un hospital especializado en salud mental. Lima, Perú

espanolIntroduccion. La depresion es un trastorno mental que en su forma mas grave puede terminar en el suicidio. Objetivo. La presente guia de practica clinica basada en evidencias (GPC-BE)brinda recomendaciones para el tratamiento farmacologico y psicoterapeutico de la depresion en adultos. Metodos. Se elaboro una GPC-BE adaptada mediante unproceso sistematico, riguroso y transparentecon un grupo elaborador conformado por metodologos y psiquiatras expertos en el manejo de la enfermedad. La guia cuenta con siete preguntas clinicas y 10 recomendaciones; se realizo la busqueda y preseleccion de GPC que respondan al alcance y objetivos planteados, las mismas que fueron evaluadas mediante el instrumento “Appraisal of Guidelines for Research and Evaluation II” (AGREE-II), seleccionandose la guia de mejor calidad metodologica para su adaptacion. La busqueda sistematica de evidencias para responder las preguntas clinicas se realizo en multiples bases de datos: MEDLINE/PubMed, EMBASE/Ovid, Cochrane Library, LILACS y SciELO. Las evidencias fueron seleccionadas y analizadas criticamente por pares clinicos y metodologicos, las recomendaciones fueron elaboradas mediante la metodologia Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Resultados. Con la participacion de un panel de expertos clinicos de diferentes hospitales de referencia en el manejo de depresion, se elaboraron 10 recomendaciones dirigidas al inicio del tratamiento farmacologico y psicoterapeutico, la terapia combinada, psicoterapia individual-grupal, y eventos adversos de la farmacoterapia en los pacientes adultos con depresion. Conclusiones. El presente articulo es un resumen de la guia de practica clinica basada en evidencias para el tratamiento de depresion en adultos para un hospital publico peruano especializado en salud mental EnglishIntroduction. Depression is a mental disorder that in its most severe form can end in suicide. Objective. This Evidence-based Clinical Practice Guideline (EB-CPG) provides recommendations for the pharmacological and psychotherapeutic treatment of depression in adults. Methods. An adapted EB-CPG was elaborated through a systematic, rigorous and transparent process with a team of methodologists and psychiatrists experts in clinical management of the disease. The guide has seven clinical questions and 10 recommendations, the search and preselection of CPGs was carried out responding to the scope and objectives, which were evaluated through the “Appraisal of Guidelines for Research and Evaluation II” (AGREE-II), and the guide with the best methodological quality was selected for methodological adaptation. A systematic search for evidence to answer the clinical questions was made in multiple databases: MEDLINE / PubMed, EMBASE / Ovid, Cochrane Library, LILACS and SciELO. The evidences were selected and critically analyzed by clinical and methodological pairs, the recommendations were elaborated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Results. With the participation of a panel of clinical experts from different reference hospitals in the clinical management of depression, 10 recommendations about the beginning of pharmacological and psychotherapeutic treatment, combined therapy, individual-group psychotherapy, and adverse drug-therapy events were approved for adult patients with depression. Conclusions. This article is a summary of the evidence-based clinical practice guidelines for the treatment of depression in adults in a Peruvian mental health public hospital