In this volume of The World Journal of Biological Psychiatry you will find an updated version of the WFSBP Guidelines for the Biological Treatment of Unipolar Depressive Disorders, specifically designed for colleagues working in primary care. These guidelines provide a comprehensive but concise manual for general practitioners and include recommendations for when to seek the help of specialists.
The philosophy behind the WFSBP treatment guidelines is to overcome national divergences and to provide a guide that is accepted by the professional community in countries with diverse psychosocial and economic backgrounds. A Task Force was set up with members of all societies of biological psychiatry affiliated with the WFSBP. I thank the 53 members of the Task Force on Unipolar Depression Disorders for their expertise, their co-operation and for the time they generously spent commenting on several drafts. Other guidelines produced by the WFSBP can be accessed via http://www.wfsbp.org/guides.html.
The treatment of depression characteristically involves a multi-professional team including primary care and specialised experts as well as co-workers supporting the patient within his or her social network. All team partners need expertise, empathy for the patient and their family and friends and the ability to interact closely with other professionals over long periods of time.
The general practitioner plays a central role in this network. The majority of patients with depression are treated in the primary care setting and are never or only occasionally seen by specialists. The general practitioner is also the person who accompanies the patient on a long-term basis and gets to know his or her needs, preferences and resources. If the importance of this role was sometimes not fully appreciated, awareness of it has increased with growing knowledge about the life-long, devastating course of the illness and the efficacy of primary care treatment approaches.
We know of the constant challenge of balancing recommendations from textbooks, experts or professional organizations with patients’ individual characteristics, situations and preferences as well as with limited resources. With the development of specifically designed versions of evidence-based consensus guidelines, the WFSBP seeks to meet the needs of target professional groups and stimulate a fruitful dialogue about how best to care for our patients. However, the data acquired in randomized controlled trials, which form the main basis of evidence-based recommendation, can only be generalized to a limited extent. With the growing number of practical trials conducted in every-day practice, this gap will hopefully be bridged in the near future.
Despite the necessity for brevity, at some points we decided to include short paragraphs with specialised treatment options in order to provide the users with knowledge of further treatment possibilities so that they can inform patients’ decision to seek specialised help. We encourage all readers to share with us their experiences and suggestions for adjustments.
In hope of your co-operation in advancing the care for patients with depression, Michael Bauer Chair of the WFSBP Task Force on Unipolar Depressive Disorders