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Revista Colombiana de Psiquiatría Guía de atención integral para la detección temprana y diagnóstico del episo...
Información de la revista
Vol. 41. Núm. 4.
Páginas 719-739 (Diciembre 2012)
Vol. 41. Núm. 4.
Páginas 719-739 (Diciembre 2012)
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Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente
Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder
Visitas
2305
Carlos Gómez-Restrepo1,
Autor para correspondencia
cgomez@javeriana.edu.co

Correspondencia: Carlos Gómez-Restrepo, Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Carrera 7° N.° 40-62 Piso 2, Bogotá, Colombia
, Adriana Patricia Bohórquez Peñaranda2, Jenny García Valencia3, Maritza Rodríguez Guarín4, Eliana Bravo Narváez5, Luis Eduardo Jaramillo6, Carlos Alberto Palacio Acosta7, Ricardo Sánchez Pedraza8, Sergio Mario Castro Díaz9
1 Médico psiquiatra, MSc Epidemiología Clínica, Psiquiatra de Enlace, Psicoanalista, profesor titular Departamento de Psiquiatría y Salud Mental, director Departamento de Psiquiatría y Salud Mental, director Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Director GAI Depresión, codirector CINETS, Bogotá, Colombia
2 Médica psiquiatra, Maestría Epidemiología Clínica, profesora Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Coordinadora GAI Depresión, Bogotá, Colombia
3 Médica psiquiatra, MSc, PhD Epidemiología, profesora Departamento de Psiquiatría, Universidad de Antioquia, Medellín, Colombia
4 Médica psiquiatra, MSc Epidemiología Clínica, profesora Departamento de Psiquiatría y Salud Mental Pontificia Universidad Javeriana, Bogotá, Colombia
5 Médica, residente de tercer año, asistente de investigación, Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia
6 Médico psiquiatra, MSc Farmacología, profesor titular Departamento de Psiquiatría, Universidad Nacional de Colombia, delegado Asociación Colombiana de Psiquiatría, Bogotá, Colombia
7 Médico psiquiatra, MSc Epidemiología Clínica, profesor titular Departamento de Psiquiatría, Universidad de Antioquia, Medellín, Colombia
8 Médico psiquiatra, MSc Epidemiología Clínica, profesor titular Departamento de Psiquiatría, Universidad Nacional de Colombia, Bogotá, Colombia
9 Médico residente Psiquiatría, asistente de investigación, Departamento de Psiquiatría y Salud Mental, Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
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Resumen
Introducción

La depresión ocupa un lugar importante como causa de morbilidad y discapacidad en el mundo; sin embargo, es subdiagnosticada en todos los niveles de atención. El objetivo es presentar las recomendaciones basadas en la evidencia que surgieron como respuesta a una serie de preguntas clínicas respecto a los factores de riesgo, tamizaje, diagnóstico y evaluación de riesgo de suicidio en pacientes con episodio depresivo y trastorno depresivo recurrente, haciendo hincapié en su enfoque en el nivel de cuidado primario, con el fin de brindar parámetros de atención en salud basados en la mejor y más actualizada evidencia disponible para lograr los estándares mínimos de calidad en el abordaje de adultos con dichos diagnósticos.

Método

Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de la Protección Social. Se adaptaron y actualizaron las recomendaciones de las guías NICE90 y CANMAT para las preguntas que estas guías contestaban y se desarrollaron de novo para las preguntas no encontradas.

Resultados

Se presentan las recomendaciones 1-22 correspondientes a tamización, riesgo de suicidio y diagnóstico de la depresión. Se incluye el grado de recomendación correspondiente.

Palabras clave:
Guía de práctica clínica
trastorno depresivo
tamizaje
factores de riesgo
suicidio
Abstract
Introduction

Depression is an important cause of morbidity and disability in the world; however, it is under-diagnosed at all care levels.

Objective

The purpose here is to present recommendations based on the evidence gathered to answer a series of clinical questions concerning risk factors, screening, suicide risk diagnosis and evaluation in patients undergoing a depressive episode and recurrent depressive disorder. Emphasis has been made upon the approach used at the primary care level so as to grant adult diagnosed patients the health care guidelines based on the best and more updated evidence available thus achieving minimum quality standards.

Methodology

A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from guides NICE90 and CANMAT were adopted and updated so as to answer the questions posed while de novo questions were developed.

Results

Recommendations 1-22 corresponding to screening, suicide risk and depression diagnosis were presented. The corresponding degree of recommendation is included.

Key words:
Practice guideline
depressive disorder
screening
risk factors
suicide
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Conflictos de interés: Los autores manifiestan que no tienen conflictos de interés en este artículo.

La Guía de Atención Integral completa fue desarrollada por el grupo que aparece en el anexo de este artículo. Este artículo-resumen fue redactado por los integrantes del grupo que se mencionan bajo el título. Financiación: El desarrollo de la Guía de Atención Integral fue financiado por el Ministerio de Salud y Protección Social y por el Departamento Administrativo de Ciencia, Tecnología e Innovación (Colciencias), mediante Contrato 126 de 2010 suscrito con la Pontificia Universidad Javeriana. Convocatoria 500 de 2009 de Colciencias (Conformación de un banco de proyectos para el desarrollo de Guías de Atención Integral (GAI) Basadas en Evidencia), fue elegido por el Consejo del Programa Nacional de Ciencia y Tecnología de la Salud, el proyecto fue liderado por la Pontificia Universidad Javeriana, en alianza con la Universidad de Antioquia y la Universidad Nacional de Colombia (Alianza CINETS).

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