Page 80 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

Medication management Medication management

Medication management is giving a person advice on how to keep to a regimen for the use of

medication (for example, how to take it, when to take it and how often). The focus in such
programmes is only on the management of medication and not on other aspects of depression.

More severe depression More severe depression

More severe depression encompasses moderate and severe depression, and in this guideline was

defined as depression scoring 16 or more on the PHQ-9 scale.

Personal and social functioning Personal and social functioning

Personal functioning represents the ability of an individual to effectively engage in the normal

activities of everyday living and react to experiences. Social functioning is the ability to interact
with other people, develop relationships and to gain from and develop these interactions.

Routine (sessional) outcome monitoring Routine (sessional) outcome monitoring

This is a system for the monitoring of the outcomes of treatments which involves regular

assessment (usually at each contact; referred to as sessional) of symptoms or personal and social
functioning using a valid scale. It can inform both service user and practitioner of progress in
treatment. It is often supported by computerised delivery and scoring of the measures which

ensures better completion of the questionnaires and service level audit and evaluation. Alternative
terms such as 'sessional outcome monitoring' or 'sessional outcomes' may also be used which
emphasise that outcomes should be recorded at each contact.

Rumination Rumination

Repetitive and prolonged negative thinking about the depression, feelings and symptoms, the self,
problems or difficult life events and about their causes, consequences, meanings and implications
(for example 'Why did this happen to me?', 'Why can I not get better?').

Stepped care or matched care Stepped care or matched care

This is a system of delivering and monitoring treatments, so that the most effective, least intrusive
and least resource intensive treatments are delivered first. Stepped care has a built in 'self-
correcting' mechanism so that people who do not benefit from initial treatments can be 'stepped
up' to more intensive treatments as needed. Matched care follows the principles of stepped care,

© NICE 2022. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 80 of
conditions#notice-of-rights). 103