Workplace : Depression Center, Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani, Thailand Background : Globally, depression is a leading cause of disability across all age groups, currently ranked the fourth in terms of burden of disease and will be ranked the second highest in 2020. Appropriate treatment and therapies are more important for reducing depressive symptoms. Therefore, clinical practice guideline of psychosocial intervention in depressive disorders should be developed for psychiatric nurses in tertiary care centers. Objective : To develop clinical practice guideline of psychosocial intervention /therapy in depressive disorder for psychiatric nurses in tertiary care centers. Material and method : Clinical practice guideline has been developed through five main processes: 1. initial draft prepared by CPG meeting group following careful review of existing practice and available published evidence on topic. International evidence-based practice and consensus statements considered and included as appropriate. All guidelines adapted to local conditions. 2. Consultation with another group member and with an appropriate external specialists where appropriate. 3. Test and evaluation with appropriate sample. 4. Draft for implementation and evaluation after implementation. 5. Continues development after implementation. Results : There are four processes of this clinical practice guideline which are as follows: 1. Severity evaluation of depressive disorder. 2. Problem evaluation related to depressive disorder. 3. Psychosocial therapy with severity; mild to moderate disorder managed with exercise or problem-solving, moderate to severe disorder managed with Cognitive-Behavior Therapy or Interpersonal Therapy 4. Outcome evaluation was done by testing 22 depressive disorder patients after therapy. There were 18 patients who received full course therapy with psychosocial intervention. It is found that severity of depressive symptom was reduced by 100 percent and satisfaction level of patients was found to be 100 percent. Clinical practice guideline of psychosocial intervention in depressive disorders for psychiatric nurses in tertiary care centers Authors : Assoc.Prof.Dr.Somporn Rungreangkulkij, Dr.Thoranin Kongsuk, Mrs.Supattra Sukhawaha, Mrs.Jintana Leejongpermpoon, Miss.Supranee Phimtra, Miss.Kedsaraporn Kenbubpha, Presenter : Kedsaraporn Kenbubpha, [email protected] Algorithm Psychosocial Intervention for MDD in Tertiary Care Settings Patients come to health services MILD (9Q=7-12) Step I Assessment Step II Planning Step III Intervention Step IV Evaluation Non history diseases to prohibit exercise and/or non specific social problem Present distorted of negative thoughts and/ or non specific relationship problem Present specific social problem and/or have diseases to prohibit exercise Present specific relationship problem Interpersonal Psychotherapy (IPT) Problem solving therapy (PST) Cognitive Behavioral Therapy (CBT) Exercise Therapy (ET) NO YES Case conference with Multidisciplinary health professionals for finding others methods Moderate (9Q= 13-18) Severe (9Q≥19) Psychiatrists diagnose to be major depressive disorder Outcome assessment of therapy with 9Q at least 6 months continuous Stop treatment Assessment severity of depressive symptoms by using 9 - questions (9Q) Assessment specific problem of depressive symptoms for choosing suitable therapy to depressed patients 9Q scores <7 or not? to to References 1. Mello M.F. et al. (2005). A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorder.Eur Arch Psychiatry Clin Neurosci.Vol 255;75-82 2. Luty S.E. et al. (2007); New Zealand. Randomized controlled trial of interpersonal psychotherapy and cognitive behavioral therapy for depression. British Journal of Psychiatry Vol.190; 496-502. 3. Bell A C, D’Zurilla T J (2009). Problem-solving therapy for depression: A metaanalysis. Clinical Psychology Review . Vol. 29; 348–353 4. Cape J (2010). Brief psychological therapies for anxiety and depression in primary care: metaanalysis and meta-regression. BMC Medicine. ; 8:38 5. Gellis Z.D.& Kenaley B. (2008). Problem-Solving Therapy for Depression in Adults: A Systematic Review. Social Work Practice. March Vol. 18 ( 2); 117-131 6. Peraton LG, Kumar S, And Machotka Z. (2010).Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. Journal of Evaluation in Clinical. Vol.16 ; 597-624. Conclusion and suggestion : This clinical practice guideline for psychiatric nurses was proved to be very effective in the reduction of depressive symptoms, with 100 percent patient satisfaction. Therefore, this guideline should be practiced in all secondary care centers and the nurses in secondary care centers should be trained for correct and effective implementation of this guideline. Keywords : clinical practice guideline, psychosocial therapy, depressive disorders, psychiatric nurses, tertiary care centers