Tvp22 01 omslag kijk verder

Tijdschrift voor Psychiatrie 46 (2004) 11, 763 - 767

Short report

Guidelines in general psychiatric practice

J. Spijker, A.J.A. Kaasenbrood, W.J. de Vries

background Little research has been done into the applicability of guidelines in general psychiatric practice.
aim To determine the applicability of a general guideline regarding the biological treatment of depression in a large institution for mental health care.
method Psychiatrists at the Gelderse Roos (an institution for mental health care) formed small focus groups in which they discussed in the course of a year to what extent actual treatment had deviated from the guideline and the reasons for these deviations. At the end of the year a postal
survey was conducted with regard to the use and validity of the guideline.
results Respondents listed numerous reasons for deviating from the guideline: some were patient-related (e.g. age, race and symptoms), some were context-related (e.g. previous treatment, patients'and doctors' preferences for non-biological interventions). In spite of these deviations psychiatrists found the guideline helpful.
conclusion A general guideline regarding the biological treatment of depression seems to have only limited applicability in a general psychiatric practice. Possible ways of dealing with this situation in the future are discussed.


keywords depression, guideline, use