Complementary and alternative medicine recommendations for depression: a systematic review and assessment of clinical practice guidelines.
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Background: Up to 50% of individuals diagnosed with depression are known to use complementary and alternative medicine (CAM). The aim of this study was to identify the quantity and assess the quality of CAM recommendations in clinical practice guidelines for the treatment and/or management of depression in adults using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Methods: A systematic review was conducted to identify depression guidelines. MEDLINE, EMBASE and CINAHL were searched from 2008 to 2018. The Guidelines International Network and the National Center for Complementary and Integrative Health websites were also searched. Eligible guidelines published by non-profit agencies on treatment of depression for adults were assessed with the AGREE II instrument twice, once for the overall guideline and once for the CAM sections. Results: From 931 unique search results, 19 guidelines mentioned CAM, of which 16 made CAM recommendations. Scaled domain percentages from highest to lowest were as follows (overall, CAM section): clarity of presentation (87.0, 66.1%), scope and purpose (80.9, 77.6%), stakeholder involvement (62.0, 44.3%), editorial independence (61.6, 61.6%), rigour of development (58.0, 52.0%), and applicability (42.2, 25.4%). Quality varied within and across guidelines. Only 1 of 16 guidelines was recommended without modifications for both its overall and CAM sections by both appraisers. Conclusions: There are multiple depression guidelines containing CAM recommendations available and there are a comprehensive set of CAM therapy options for depression. The quality of guidelines varied within and across guidelines and the quality of CAM recommendations was generally lower than the overall recommendations in the guidelines for all domains except editorial independence. Generally, characteristics of guidelines, including the year of publication and region of development varied across the guidelines irrespective of quality. Guidelines with higher AGREE II scores can serve as a guide to facilitate communication between patients and medical professionals regarding CAM use for depression, while guidelines with lower scores could be improved in future updates using the AGREE II instrument as a guide.
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Many global guidelines and recommendations for the treatment of depression advocate the use of high-intensity light therapy as an effective treatment approach.
“Furthermore, many global guidelines and recommendations for the treatment of depression advocate the use of high-intensity light therapy as an effective treatment approach.[52–54]”
From Effectiveness of visible light for seasonal affective disorder: A systematic review and network meta-analysis (2025) · cites this paper as [53]
The Results (Guideline characteristics; page unavailable) report that five of 16 depression guidelines included recommendations concerning (bright) light therapy. The passage does not specify high-intensity light or establish that those guidelines advocated it as an effective treatment, so those parts of the claim are not supported by our copy. (LLM, conf=0.84)
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Self-citationBsoul, N., Liang, N., Cai, L., Mazmanyan, D., & Porter, D. E. (2024) · Figshare · doi:10.6084/m9.figshare.26211366
Ng, J. Y., Liu, H., & Wang, M. C. (2024) · Figshare · doi:10.6084/m9.figshare.26603569
Self-citationBsoul, N., Liang, N., Cai, L., Mazmanyan, D., & Porter, D. E. (2024) · Figshare · doi:10.6084/m9.figshare.26211633
Sobieraj, J., Sleziak, J., Szyszka, M., Błażejewska, M., Łukańko, K., Soczomska, P., Bodziony, K., & Piotrowski, P. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1734137
Baune, B., Prabhakaran, A., Patel, M., Grübel, S. E. F., Varma, J., Patel, M., & Gupta, S. N. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1719639
Voderholzer, U., Wuttke, E. P., Zisler, E. M., Baumeister, A., & Jelinek, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1843041
Oorschot, T., Adams, J., & Sibbritt, D. W. (2026) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-026-05413-3
- Authors
- Ng, J. Y., Nazir, Z., & Nault, H.
- Affiliations
- McMaster University (CA)
- Corresponding author
- Ng, Jeremy Y.
- Venue
- BMC Complementary Medicine and Therapies
- Published
- 2020-10-07
- Volume
- 20
- Issue
- 1
- Pages
- 299-299
- ISSN
- 2662-7671 (ISSN-L)
- PMC
- PMC7541317
- OpenAlex
- W3092388380
- Cited by
- 39
- References
- 69
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 13 · 2023: 5 · 2022: 6 · 2021: 5
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Complementary Medicine and Therapies (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- McMaster University
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- complementary and alternative medicine, depression, guideline quality, AGREE II, guideline development
- MeSH terms
- Complementary Therapies, Depression, Humans, Practice Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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