Abstract
The recently published RANZCP mood disorders clinical practice guidelines (MDcpg2020) provide an excellent contemporary overview of the aetiology, classification and (suggestive, but nonprescriptive) management of mood disorders (Malhi et al., 2021). Recommendations are evidence-based or, where the evidence is insufficient, consensus-based – here the knowledge and experience of the authors come to the fore. Though some have criticized the document for being more textbook than guideline (e.g. there are 61 pages of information prior to any specific mood disorder management recommendation), overall the authors ought to be commended on a fine publication. (Lugg, 2021)
We welcome Dr Lugg’s endorsement, and are delighted that our efforts to provide context and broader information regarding the management of mood disorders has hit the mark. We also welcome his constructive suggestions and indeed share the vision articulated for future iterations of clinical practice guidelines (CPGs). Specifically, we wholeheartedly agree with the proposal of developing ‘a live, modular, MDcpg2020 [that] 1 could be continuously updated and adjusted as new evidence (or consensus) arises’. The flexibility and adaptability that this would afford is increasingly needed in order to provide information that is up-to-date and to allow clinicians to have easier access via a variety of formats. One of the key themes in the MDcpg2020 is recognition of multiple types of expertise (research, clinical, lived experience) that optimally come together in the individual case to drive treatment decisions. Hence, we are enthusiastic about the possibility of a digital platform that is not only live and modular, but also represents a broader epistemology than the traditional clinical guideline.
However, we also feel that retaining the capacity for some sections to be easily printed is essential. For example, with the current CPGs, we have created a number of one-page figures (26, 27, 28, 30, 32) that summarise the management of key aspects of mood disorders. These were developed in response to feedback from the previous guidelines (Malhi et al., 2015), where many clinicians valued having a single one-page summary that could be printed and given to patients, displayed on walls, or maintained as a desk reference. This could be expanded further, so as to have digital formats that are compatible with modern day mobile devices, such as tablets and smartphones. And so, even though we have only recently published the MDcpg2020, we champion the development of the MDcpg2020 2.0!
Footnotes
Declaration of Conflicting Interests
The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: G.S.M. has received grant or research support from National Health and Medical Research Council, Australian Rotary Health, NSW Health, American Foundation for Suicide Prevention, Ramsay Research and Teaching Fund, Elsevier, AstraZeneca, Janssen-Cilag, Lundbeck, Otsuka and Servier; and has been a consultant for AstraZeneca, Janssen-Cilag, Lundbeck, Otsuka and Servier. D.B. has received funding to host webinars by Lundbeck. P.B. has received research support from the National Health and Medical Research Council; speaker fees from Servier, Janssen and the Australian Medical Forum; and educational support from Servier and Lundbeck; has been a consultant for Servier; served on an advisory board for Lundbeck; and has served as DSMC Chair for Douglas Pharmaceuticals. R.M. has received support for travel to education meetings from Servier and Lundbeck, and speaker fees from Servier and Committee fees from Janssen. G.M. has received grant support in the last 5 years from the National Health and Medical Research Council, the Mental Illness Research Fund, Victorian Medical Research Acceleration Fund, Canadian Institutes of Health Research, Readiness, SiSU Wellness and Barbara Dicker Foundation. M.H. has received grant or research support in the last 5 years from the National Health and Medical Research Council, Medical Research Future Fund, Ramsay Health Research Foundation, Boehringer-Ingleheim, Douglas, Janssen-Cilag, Lundbeck, Lyndra, Otsuka, Praxis and Servier; and has been a consultant for Janssen-Cilag, Lundbeck, Otsuka and Servier. A.S. has shares/options in Baycrest Biotechnology Pty Ltd (pharmacogenetics company) and Greenfield Medicinal Cannabis, and has received speaking honoraria from Servier, Lundbeck and Otsuka Australia. R.P. has received support for travel to educational meetings from Servier and Lundbeck and uses software for research at no cost from Scientific Brain Training Pro. The author E.B. declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
