gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Recommendation for psychotherapy, antidepressants and their combination in Clinical Guidelines – does a further differentiation of interventions make sense?

Meeting Abstract

  • T. Harfst - German Chamber of Psychotherapists, Berlin, Germany
  • R. Richter - German Chamber of Psychotherapists, Berlin, Germany
  • J. von Wietersheim - University Clinic for Psychosomatic Medicine and Psychotherapy, Ulm, Germany
  • H. Reinecker - Otto-Friedrich-University of Bamberg, Bamberg, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP076

doi: 10.3205/12gin188, urn:nbn:de:0183-12gin1884

Published: July 10, 2012

© 2012 Harfst et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Clinician Guidelines assist practitioners in making decisions about appropriate health care for specific clinical circumstances. For many mental disorders psychotherapy, antidepressants or their combination are recommended as first line treatments. A so far unresolved problem concerns the question which degree of further differentiation of the specific type of these interventions is sensible and perhaps necessary considering the existing evidence base. Quite often there is a lack of comparative clinical studies of good quality that demonstrate a clinically relevant superiority of a specific treatment (e.g., CBT vs. psychodynamic therapy). At the same time there may be a larger evidence base for one specific treatment option in terms of its superiority against placebo control or clinical management. Therefore guidelines developers have to decide which pattern of evidence justifies a first-line treatment recommendation for a specific intervention when evidence for its specific superiority is lacking.

Objectives/Goal: On the basis of the analysis of recommendations and their underlying evidence of the German Clinical Guidelines for the treatment of unipolar depression, eating disorders and obsessive-compulsive disorders in comparison with the corresponding NICE Guidelines a possible rationale for this decision making process will be discussed.

Target group, suggested audience: mental health care professionals, guideline developers


German National Disease Management Guideline „Unipolar Depression” – Specificity of treatment recommendations and its evidence base
Clinical Guideline „Diagnosis and Treatment of Eating Disorders“ – Specificity of treatment recommendations and its evidence base
Clinical Guideline „Obsessive-compulsive disorders“ – Specificity of treatment recommendations and its evidence base