Major depression advances in diagnosis and therapeutic perspectives: Literature review

Abstract

Introduction: Major depression represents a significant challenge for health systems, given its high prevalence, impact on quality of life, risk of comorbidities, and associated morbidity. In addition to pharmacological and psychotherapeutic treatment, physiotherapy has proven to be an important ally in promoting mental health, contributing to improved functionality, sleep, physical conditioning, and mood regulation. Early diagnosis, continuous follow-up, and integrated therapeutic strategies are essential to reduce recurrence, optimize clinical outcomes, and promote patient functionality. Objective: A literature review was conducted to synthesize evidence on advances in diagnosis and therapeutic perspectives for major depression, including pharmacological, psychotherapeutic, and combined interventions, as well as emerging strategies for monitoring and personalizing care. Methods: This is a descriptive and analytical literature review based on national and international publications available in the Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (LILACS), PubMed, and Scopus databases. Original articles, systematic reviews, clinical trials, observational studies, theoretical reviews, and qualitative studies published between 2018 and 2025, in Portuguese and English, were included. Opinion pieces, interviews, and duplicate materials were excluded. Study selection occurred in three stages: identification and removal of duplicates, screening of titles and abstracts, and full-text reading of eligible articles. Results: The literature indicates that combined therapeutic strategies involving pharmacotherapy and psychotherapy, associated with physiotherapeutic programs of supervised physical activity, functional rehabilitation, and relaxation techniques, are linked to reduced symptom severity, greater treatment adherence, decreased recurrence, and improved quality of life. Studies highlight the importance of early diagnosis, recognition of prodromal signs, and personalization of interventions to optimize clinical outcomes. Barriers include inequalities in access to specialized services, limited implementation of innovative therapies, and the need for continuous professional training. Conclusion: The management of major depression depends on early diagnosis, combined and individualized therapeutic strategies, longitudinal follow-up, and integration between pharmacological and psychotherapeutic interventions. The inclusion of physiotherapy as a component of interdisciplinary care contributes to functional recovery, improved quality of life, and prevention of relapses. Emerging therapeutic advances and personalized approaches enhance adherence, clinical efficacy, and recurrence reduction. Investments in professional training, monitoring technologies, and structured protocols are essential to expand the benefits of care and improve patient outcomes.