Background Depressive disorder are among the most common illnesses and reasons for obtaining health care. are useful aids to diagnostic classification. When a treatment is definitely chosen shared decision-making with the patient is essential. Mild depressive episodes can be treated in the beginning by watchful waiting for 14 days. For moderate depressive episodes pharmacotherapy and psychotherapy are equally effective treatment options. For severe major depression a combination of pharmacotherapy and psychotherapy is recommended. If 4 to 6 6 weeks of acute therapy are insufficiently effective lithium augmentation is recommended rather than combination antidepressant therapy or a switch to another antidepressant. After remission maintenance therapy should be continued for 4 to 9 weeks. In recurrent major depression pharmacotherapy and/or psychotherapy where appropriate should be continued for at least two years. Specific recommendations are given for patients who have somatic or mental comorbidities or are acutely suicidal and recommendations are also given for coordination of care. Conclusion This guideline is a comprehensive set of evidence- and consensus-based recommendations for the diagnosis and treatment of unipolar depression. An improvement in PD184352 the care of patients with unipolar depression will require broad implementation of the guideline both in the inpatient and outpatient setting. The importance of unipolar depression as a common and widespread illness is continually increasing. With a lifetime prevalence of 16% to 20% depressive disorders range among the most common pathologies and causes for health consultations in Germany (1). Adequate and timely diagnosis of depressive disorders bear great potential for improvements in health services and an equally promising approach is to base diagnostic evaluation and treatment on evidence-based recommendations and stepwise and networked or interdisciplinary health care (2 3 The S3 clinical practice guideline was initiated by the German Association for Psychiatry and Psychotherapy (2). A steering group was formed to develop the clinical PD184352 practice guideline and coordinate the PD184352 consensus conferences. This group was consulted for the background texts set out by the coordination team and prepared new suggestions for decisions on this basis (5 6 ebox 1 Participating medical societies professional associations organizations for family and relatives and self help organizations German Association for Psychiatry and Psychotherapy (Deutsche Gesellschaft für Psychiatrie PD184352 Psychotherapie und Nervenheilkunde DGPPN) Drug Commission of the German Medical Association (Arzneimittelkommission der deutschen ?rzteschaft Akd?) Federal Chamber of Psychotherapists in Germany (advisory) (Bundespsychotherapeutenkammer BPtK) German association for the relatives of people with mental health problems (Bundesverband der Angeh?rigen psychisch Kranker BApK) German Functioning Group for Self-help Organizations (Deutsche Arbeitsgemeinschaft Selbsthilfegruppen DAGSHG) German University Rabbit Polyclonal to C1S. of General Professionals and Family Doctors (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin DEGAM) German Culture of Psychosomatic Medication and Medical Psychotherapy (Deutsche Gesellschaft für Psychosomatische Medizin und ?rztliche Psychotherapie DGPM) German Psychological Culture (Deutsche Gesellschaft für Psychologie DGPs) German Culture for Treatment Sciences (Deutsche Gesellschaft für Rehabilitationswissenschaften DGRW) Federal government Meeting of Clinical Directors of Psychiatric Private hospitals (and functioning group for melancholy wards) (Bundesdirektorenkonferenz psychiatrischer Krankenh?consumer [und Arbeitskreis Depressionsstationen] BDK) Functioning band of Clinical Directors of Private hospitals for Psychiatry and Psychotherapy in General Private hospitals in Germany (Arbeitskreis PD184352 der Chef?rztinnen und Chef?rzte von Kliniken für Psychiatrie und Psychotherapie an Allgemeinkrankenh?usern in Deutschland ACKPA) Association of German Professional Psychologists (Berufsverband Deutscher Psychologinnen und Psychologen BDP) Professional Association of Professionals in Psychosomatic Medication and Psychotherapy in Germany (Berufsverband der Fach?rzte für Psychosomatische Medizin und Psychotherapie Deutschlands BPM) Professional Association of German Psychiatrists/Neurologists (Berufsverband Deutscher Nerven?rzte BVDN) Professional Association of German Psychiatrists (Berufsverband Deutscher Psychiater BVDP) German Federal government Association of Agreement Psychotherapists (Bundesverband der.