10368nam a22003137a 450000500170000000800410001702000220005804000140008024501390009425700100023326000480024330000110029152094070030265000170970965000240972665000120975065000170976265000170977965000130979665000220980965000130983165000220984465000130986665000180987965000130989765500140991071000300992485601000995420240109132248.0240109s2023 ||||| |||| 00| 0 eng d a978-92-4-008427-8 aCOPMbspa00aMental health gap action programme (mhGAP) guideline for mental, neurological and substance use disordersc/ World Health Organization aSuiza aGenevab: World Health Organizationc; 2023 a184 p. aEsta 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. 1. Introduction Background and rationale. Aims and objectives. Target audience. Scope of the guideline 2. Methods Contributors to the guideline. Declaration of interests. Identifying, appraising and synthesizing available evidence. Decision-making during the GDG meetings. Document preparation and peer review 3. Recommendations Alcohol use disorders (ALC) In adults with alcohol dependence post-detoxification, is baclofen effective for relapse prevention and management of alcohol dependence? In adults with alcohol dependence, are psychosocial interventions effective? In adults with alcohol use disorders or hazardous drinking, are digital interventions effective? In adults with alcohol use disorders, are combined pharmacological and psychosocial interventions effective and safe? Anxiety (ANX) 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? 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)? For adults with anxiety disorders, what is the comparative effectiveness of different formats of psychological interventions? 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)? 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)? Are benzodiazepines better than (more effective than/as safe as) placebo for adults with anxiety disorders (excluding social anxiety disorders and specific phobias)? 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)? Child and adolescent mental disorders (CAMH) What is the effectiveness and safety of pharmacological interventions for children with a diagnosis of attention deficit hyperactivity disorder (ADHD)? What is the effectiveness of psychosocial interventions for promotion of mental health and prevention of mental health conditions in children? 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? In children and adolescents with emotional disorders, what is the effectiveness and safety of using pharmacological interventions? Conditions related to stress (STR) For adults with post-traumatic stress disorder (PTSD), are psychological interventions effective compared with treatment as usual, waitlist or no treatment? For children and adolescents with PTSD, are psychological interventions effective compared with treatment as usual, waiting list or no treatment? Dementia (DEM) For carers of people with dementia, are psychosocial interventions effective in improving their outcomes? 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? For people with dementia, are non-pharmacological interventions effective in improving their outcomes? Depression (DEP) 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? How long should treatment with antidepressants continue in adults with depressive episode/disorder? Is brief, structured psychological treatment better than (more effective than/as safe as) treatment as usual in adults with depressive episode/disorder? In adults with moderate-to-severe depressive disorder, what is the effectiveness and safety of antidepressant medicine compared with psychological treatment? Drug use disorders (DRU) Are brief psychosocial interventions for people using cannabis or stimulants effective in reducing drug use, dependence and harm from drug use? Are pharmacotherapies safe and effective for the treatment of cocaine or stimulant dependence? Which psychosocial interventions are effective in the treatment of stimulant dependence for adults? In adults with drug use disorders or using drugs, are digital or telemedicine interventions effective? In adults with drug dependence, are recovery-oriented services effective? Epilepsy and seizures (EPI) 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)? 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)? For adults and children with epilepsy, which antiseizure medicines are effective and safe? What is the effectiveness and safety of antiseizure medicines in women of childbearing potential? Which interventions are effective in preventing epilepsy-related mortality, including sudden unexpected death of someone with epilepsy (SUDEP)? Overarching areas (OVE) 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? Psychosis and bipolar disorder (PSY) In adults with psychotic disorders (including schizophrenia) is antipsychotic medicine safe and effective? 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? 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? In adults with psychotic disorders (including schizophrenia) requiring long-term treatment, what is the safety and role of depot antipsychotic medicine? Is antipsychotic medicine effective and safe for adolescents with psychotic disorders (including schizophrenia)? Is psychotropic medicine effective and safe for adolescents with bipolar disorder? In adults with bipolar disorder (current episode mania), are antipsychotic medicines and mood stabilizers effective and safe? In adults with bipolar disorders in remission, are mood stabilizers and antipsychotics effective and safe? In adults presenting with a depressive episode in bipolar disorder, are medicines with antidepressant effects (adjunct to maintenance treatment) effective and safe? In adults with psychotic disorders (including schizophrenia), are psychological interventions (such as psychoeducation, family interventions and cognitive behavioural therapy) effective in the acute phase? In adults with psychotic disorders (including schizophrenia), are psychological interventions (such as psychoeducation, family interventions and CBT) effective in the maintenance phase? In adults with bipolar disorder in remission, are psychological interventions (such as psychoeducation, family interventions and CBT) effective? Self-harm and suicide (SUI) 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? Are suicide prevention media campaigns effective in reducing deaths from suicide, suicide attempts and acts of self-harm? 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? 4. Publication Publication and dissemination of the guideline Derivative products WHO model list of essential medicines (EML) 5. Monitoring and evaluating the impact of the guideline 6. Updating the evidence 17aSalud mental17aTrastornos mentales17aNiños17aAdolescentes17aNeurología17aAnsiedad17aDepresión mayor17aDemencia10aDrogodependencias17aPsicosis17aEsquizofrenia17aSuicidio 4aPsiLibros aWorld Health Organization41uhttps://www.consaludmental.org/publicaciones/Mental-Health-Gap-Action.pdfyAcceso electrónico