What has Nice announced?
The National Institute for Health and Care Excellence (Nice) has developed the first new guidelines for 12 years to identify, treat and manage depression in adults.
How many people are affected by depression?
According to the Office for National Statistics (ONS), about one in six (17%) adults experienced some form of depression this summer. The rate is higher than before the pandemic, when 10% of adults experienced it. Younger adults and women are more likely to be affected, the ONS found.
Who will be affected by the changes?
Nice has drawn up guidance for health professionals when treating patients in two broad categories: those with “less severe depression” and those with “more severe depression”.
What is “less severe depression”, and what does the new guidance say?
This group includes those deemed to have “sub-threshold” or “mild depression”. Sub-threshold means fewer than five symptoms of depression, Nice said, while mild depression includes those with few, if any, symptoms in excess of the five required to make the diagnosis, and whose symptoms result in only minor functional impairment. The new guideline suggests patients with less severe depression should be offered therapy, exercise, mindfulness or meditation before antidepressants.
What about “more severe depression”?
This includes people who suffer from moderate or severe depression. A similar range of psychological interventions, along with the option of antidepressant medication, should be available to these people when choosing a primary treatment.
Is the new guidance final?
No – these are draft guidelines which are now subject to consultation.
Are the guidelines mandatory?
When exercising their judgment, health professionals are expected to take the guidelines fully into account, alongside the individual needs, preferences and values of their patients or the people using their service, Nice said.
It is not mandatory to apply the recommendations, and the guidelines do not override the responsibility to make decisions appropriate to the circumstances of the patient, in consultation with them and their family, carers or guardians.