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KMID : 0368820210600040275
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Journal of the Korean Neuropsychiatr Association
2021 Volume.60 No. 4 p.275 ~ p.283
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Korean Medication Algorithm Project for Depressive Disorder 2021 (VI): Non-Pharmacological Biological Treatments
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Jeong Jong-Hyun
Woo Young-Sup
Bahk Won-Myong
Wang Sheng-Min
Seo Jeong-Seok
Park Young-Min
Kim Won
Shim Se-Hoon
Lee Jung-Goo
Jang Seung-Ho
Yang Chan-Mo
Jung Myung-Hun
Sung Hyung-Mo
Choo Il-Han
Yoon Bo-Hyun
Lee Sang-Yeol
Jon Duk-In
Min Kyung-Joon
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Abstract
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Objectives The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was made to update new researches and data. This study focused on non-pharmacological biological treatments.
Methods Ninety-seven psychiatrists with extensive clinical experience in the non-pharmacological biological treatment of depressive disorder were primary selected and a questionnaire was sent to each of them by mail, 65 of the 97 replied.
Results Electroconvulsive therapy (ECT) was recommended as an initial strategy for major depressive disorder, severe depressive disorder with/without psychotic features with urgent suicidal risk, or a severe depressive episode with psychotic features in pregnant patients, for non-responders on pharmacotherapy for a moderate depressive episode, and as a second strategy for non-responders on antidepressant monotherapy or combination therapy combined with physical illness. For pregnant women with a severe episode of major depressive disorder, repetitive transcranial magnetic stimulation (rTMS) was preferred as a first-line strategy, and as a second strategy for non-responders on combined antipsychotic and antidepressant therapy and non-responders with comorbidity and physical illness. Complementary or novel treatment was not recommended as the first-line treatment strategy for depressive disorder, but transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), deep brain stimulation (DBS), light therapy, and omega-3 fatty acid nutritional therapy were second-line treatment strategies.
Conclusion ECT and rTMS are initial strategies in specific clinical situations. Preferences for complementary or novel treatments such as tDCS, light therapy, and omega-3 fatty acid nutritional therapy have increased gradually, but in practice, their usages are still limited.
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KEYWORD
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Korean Medication Algorithm Project for Depressive Disorder 2021, Major depressive disorder, Non-pharmacological biological treatments
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