Korean Medication Algorithm Project for Depressive Disorder 2021 (VI): Non-Pharmacological Biological Treatments
10.4306/jknpa.2021.60.4.275
- Author:
Jong-Hyun JEONG
1
;
Young Sup WOO
;
Won-Myong BAHK
;
Sheng-Min WANG
;
Jeong Seok SEO
;
Young-Min PARK
;
Won KIM
;
Se-Hoon SHIM
;
Jung Goo LEE
;
Seung-Ho JANG
;
Chan-Mo YANG
;
Myung Hun JUNG
;
Hyung Mo SUNG
;
IL Han CHOO
;
Bo-Hyun YOON
;
Sang-Yeol LEE
;
Duk-In JON
;
Kyung Joon MIN
Author Information
1. Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Korean Neuropsychiatric Association
2021;60(4):275-283
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
