| Resumen |
Esta guía reúne información y recomendaciones para afrontar la actual situación de problemas de salud mental, enfermedades neurológicas y consumo de sustancias e intentar reducir el déficit de atención de estos problemas de salud. Esta nueva edición de este programa de la OMS pretende ofrecer una orientación de calidad, eficiente, transparente y basada en la evidencia para apoyar a los y las profesionales de la salud no especializados en países de ingresos bajos y medios para la atención a las personas.<br/><br/><br/>1. Introduction<br/>Background and rationale. Aims and objectives. Target audience. Scope of the guideline <br/><br/>2. Methods<br/>Contributors to the guideline. Declaration of interests. Identifying, appraising and synthesizing available evidence. Decision-making during the GDG meetings. Document preparation and peer review <br/><br/>3. Recommendations<br/>Alcohol use disorders (ALC) <br/>In adults with alcohol dependence post-detoxification, is baclofen effective for relapse prevention and management of alcohol dependence?<br/>In adults with alcohol dependence, are psychosocial interventions effective?<br/>In adults with alcohol use disorders or hazardous drinking, are digital interventions effective? <br/>In adults with alcohol use disorders, are combined pharmacological and psychosocial interventions effective and safe? <br/><br/>Anxiety (ANX)<br/>In adults with anxiety disorders (excluding social anxiety disorder and specific phobias), are antidepressants (tricyclic antidepressants [TCAs] and selective serotonin reuptake inhibitors [SSRIs]) effective and safe compared with treatment as usual, waitlist, no treatment, or alternative psychological or pharmacological treatments?<br/><br/>Is brief, structured psychological treatment (e.g. cognitive behavioural therapy [CBT], problem-solving therapy [PST]) better than treatment as usual in people with anxiety disorders (excluding social anxiety disorder and specific phobias)?<br/><br/>For adults with anxiety disorders, what is the comparative effectiveness of different formats of psychological interventions?<br/><br/>Are stress management techniques better than (more effective than/as safe as) treatment as usual in adults with anxiety disorders (excluding social anxiety disorder and specific phobias)?<br/><br/>Is advice on physical activity better than (more effective than/as safe as) treatment as usual, waitlist, no treatment in adults with anxiety disorders (excluding social anxiety disorders and specific phobias)?<br/><br/>Are benzodiazepines better than (more effective than/as safe as) placebo for adults with anxiety disorders (excluding social anxiety disorders and specific phobias)? <br/><br/>Is collaborative care better than (more effective than/as safe as) treatment as usual, waitlist, no treatment for adults with depression or anxiety (living with chronic health conditions)? <br/><br/>Child and adolescent mental disorders (CAMH)<br/>What is the effectiveness and safety of pharmacological interventions for children with a diagnosis of attention deficit hyperactivity disorder (ADHD)?<br/> <br/>What is the effectiveness of psychosocial interventions for promotion of mental health and prevention of mental health conditions in children?<br/><br/>What is the effectiveness of psychosocial interventions (apart from caregiver skills training) to improve development, wellbeing, functioning and school participation in children and adolescents with neurodevelopmental delays and disabilities?<br/><br/>In children and adolescents with emotional disorders, what is the effectiveness and safety of using pharmacological interventions?<br/><br/>Conditions related to stress (STR)<br/>For adults with post-traumatic stress disorder (PTSD), are psychological interventions effective compared with treatment as usual, waitlist or no treatment?<br/><br/>For children and adolescents with PTSD, are psychological interventions effective compared with treatment as usual, waiting list or no treatment?<br/><br/>Dementia (DEM)<br/>For carers of people with dementia, are psychosocial interventions effective in improving their outcomes?<br/><br/>For people with dementia and comorbid depression, do psychological interventions (including cognitive behavioural therapy, behavioural activation therapy, interpersonal therapy and counselling) produce any benefit and/or harm compared with controls?<br/><br/>For people with dementia, are non-pharmacological interventions effective in improving their outcomes?<br/><br/>Depression (DEP)<br/>Are antidepressants (tricyclic antidepressants [TCAs] and selective serotonin reuptake inhibitors [SSRIs]) better than (more effective than/as safe as) pill placebo/treatment as usual in adults with depressive episode/disorder?<br/>How long should treatment with antidepressants continue in adults with depressive episode/disorder?<br/><br/>Is brief, structured psychological treatment better than (more effective than/as safe as) treatment as usual in adults with depressive episode/disorder?<br/><br/>In adults with moderate-to-severe depressive disorder, what is the effectiveness and safety of antidepressant medicine compared with psychological treatment?<br/><br/>Drug use disorders (DRU)<br/>Are brief psychosocial interventions for people using cannabis or stimulants effective in reducing drug use, dependence and harm from drug use?<br/><br/>Are pharmacotherapies safe and effective for the treatment of cocaine or stimulant dependence?<br/><br/>Which psychosocial interventions are effective in the treatment of stimulant dependence for adults?<br/><br/>In adults with drug use disorders or using drugs, are digital or telemedicine interventions effective? <br/><br/>In adults with drug dependence, are recovery-oriented services effective?<br/><br/>Epilepsy and seizures (EPI)<br/>In adults with established status epilepticus, i.e. seizures persisting after the first-line agent (benzodiazepine-resistant status epilepticus), which antiseizure medicines are associated with better clinical outcomes (stopping seizures and with less adverse effects)? <br/><br/>In children with established status epilepticus, i.e. seizures persisting after the first-line agent (benzodiazepine‐resistant status epilepticus), which antiseizure medicines are associated with better clinical outcomes (stopping seizures and with less adverse effects)?<br/><br/>For adults and children with epilepsy, which antiseizure medicines are effective and safe?<br/><br/>What is the effectiveness and safety of antiseizure medicines in women of childbearing potential?<br/><br/>Which interventions are effective in preventing epilepsy-related mortality, including sudden unexpected death of someone with epilepsy (SUDEP)?<br/><br/>Overarching areas (OVE)<br/>Are psychosocial interventions (i.e. psychoeducation, cognitive-behavioural therapy, counselling, self-help groups) for carers of persons with schizophrenia/psychosis/schizophrenia spectrum disorder, bipolar disorder or substance use disorder effective compared with placebo/other controls?<br/><br/>Psychosis and bipolar disorder (PSY)<br/><br/>In adults with psychotic disorders (including schizophrenia) is antipsychotic medicine safe and effective?<br/><br/>In adults with a first psychotic episode (schizophrenia) with full remission, how long should antipsychotic medicine be continued after remission in order to allow for the best outcomes?<br/><br/>In adults with bipolar disorder in remission, how long should antipsychotic medicine or mood stabilizers be continued after remission in order to allow for the best outcomes?<br/><br/>In adults with psychotic disorders (including schizophrenia) requiring long-term treatment, what is the safety and role of depot antipsychotic medicine? <br/><br/>Is antipsychotic medicine effective and safe for adolescents with psychotic disorders (including schizophrenia)?<br/><br/>Is psychotropic medicine effective and safe for adolescents with bipolar disorder?<br/><br/>In adults with bipolar disorder (current episode mania), are antipsychotic medicines and mood stabilizers effective and safe?<br/><br/>In adults with bipolar disorders in remission, are mood stabilizers and antipsychotics effective and safe?<br/><br/>In adults presenting with a depressive episode in bipolar disorder, are medicines with antidepressant effects (adjunct to maintenance treatment) effective and safe?<br/><br/>In adults with psychotic disorders (including schizophrenia), are psychological interventions (such as psychoeducation, family interventions and cognitive behavioural therapy) effective in the acute phase?<br/><br/>In adults with psychotic disorders (including schizophrenia), are psychological interventions (such as psychoeducation, family interventions and CBT) effective in the maintenance phase?<br/><br/>In adults with bipolar disorder in remission, are psychological interventions (such as psychoeducation, family interventions and CBT) effective?<br/><br/>Self-harm and suicide (SUI)<br/><br/>Is safety planning better than treatment as usual for persons with thoughts or plans of self-harm in the last month or acts of self-harm in the last year?<br/><br/>Are suicide prevention media campaigns effective in reducing deaths from suicide, suicide attempts and acts of self-harm?<br/><br/>Are stand-alone digital interventions for the self-management of thoughts, plans or acts of self-harm among persons with thoughts or plans of self-harm in the last month or acts of self-harm in the last year effective in reducing deaths from suicide, suicide attempts, acts and thoughts of self-harm?<br/><br/>4. Publication<br/>Publication and dissemination of the guideline<br/>Derivative products<br/>WHO model list of essential medicines (EML)<br/><br/>5. Monitoring and evaluating the impact of the guideline<br/><br/>6. Updating the evidence<br/><br/> |