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Recommendations Summary

UWL: Evaluation and Treatment of Depression 2009

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    UWL: Evaluation and Treatment of Depression

    The registered dietitian (RD) should collaborate with other healthcare professionals to consider evaluation and treatment of depression for patients who are undernourished or at risk of undernutrition when medical nutrition therapy (MNT) interventions have not resulted in improved nutrient intake or stabilization of weight. Research reports an association between depression and weight loss or poor nutritional status.

    Rating: Strong
    Conditional

    • Risks/Harms of Implementing This Recommendation

      None.

    • Conditions of Application

      This recommendation applies when medical nutrition therapy (MNT) interventions have not resulted in improved nutrient intake or stabilization of weight.

    • Potential Costs Associated with Application

      There are costs associated with evaluation and treatment for depression.

    • Recommendation Narrative

      • 12 studies were evaluated regarding the association between underweight or weight loss and depression in adults over age 65
      • Four studies report an association between weight loss or poor nutritional status and depression (Thomas et al, 2002; Callen and Wells, 2005; Chen et al, 2005; Woods et al, 2005), while two studies report no association between low BMI and depression (Crogan and Pasvogel, 2003; Shum et al, 2005)
      • Additional studies report that weight loss may be common in depressed individuals with Alzheimer's disease (Purandare et al, 2001; Starkstein et al, 2005), individuals who are recently widowed (Schulz et al, 2001; Shahar et al, 2001), demented individuals (Thomas et al, 2003) and individuals on antidepressant therapies (Rigler et al, 2001). Further research is needed in these areas.

    • Recommendation Strength Rationale

      Conclusion statement in support of this recommendation received Grade II.

    • Minority Opinions

      Consensus reached.