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014 Development of a decision aid for major depressive disorder based on the Japanese guidelines for the depression treatment
  1. Yumi Aoki1,
  2. Takashi Tsuboi2,
  3. Hitoshi Iida3,
  4. Yoshie Sakai4,
  5. Yoshikazu Takaesu5,
  6. Hikaru Hori3,
  7. Koichiro Watanabe2,
  8. Hiroaki Kawasaki3,
  9. The Psychoeducation Committee of the Japanese Society of Mood Disorders
  1. 1Psychiatric and Mental Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
  2. 2Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
  3. 3Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
  4. 4Department of Clinical Psychology, Faculty of Psychology, Atomi University, Tokyo, Japan
  5. 5Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan


Introduction Evidence-based treatments are available for major depressive disorder (MDD); however, standard approaches for implementing shared decision-making (SDM) in clinical settings while concurrently sharing relevant evidence with individuals with MDD have not been established. This study aimed to develop a decision aid (DA) to facilitate SDM for individuals with MDD based on the Japanese guidelines for depression treatment.

Methods Part I involved the formation of a steering group comprised of presenters, who are members of the Psychoeducation Committee of the Japanese Society of Mood Disorders. The DA was systematically developed in accordance with the International Patient Decision Aid Standards. Drafting occurred through online meetings, utilizing evidence from Japanese depression treatment guidelines. Part II entails administering a mixed-methods questionnaire (alpha acceptability testing) survey to individuals with MDD and healthcare providers. This aims to enhance the DA prototype and adapt it for clinical settings by incorporating feedback.

Results In Part I, the DA began with psychoeducational content on depression, a fundamental intervention for all MDD diagnoses. It included explanations of symptoms, triggers, and mechanisms of depression. Treatment options were tiered by depression severity, offering distinct recommendations. For mild depression, options included medication and cognitive-behavioral therapy, while moderate to severe cases involved medication and modified electroconvulsive therapy. Medication recommendations varied by severity, encompassing novel antidepressants for mild cases and novel/tricyclic/non-tricyclic antidepressants for moderate to severe cases. Pros and cons of these options were presented in comparative tables, accompanied by value exercise sheets to clarify personal values. Part II is currently underway.

Conclusion Results, including alpha acceptability testing, will be presented at the conference. The intention is to share the DA on the website of the Japanese Society of Depression, ensuring broad accessibility for the general public and healthcare providers in Japan.

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