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Depression in adults: treatment and management (NG222)

discussions to support informed choice, but a positive choice may improve engagement and

outcomes.

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Behavioural couples therapy Behavioural couples therapy

Recommendation 1.7.1

Why the committee made the recommendation Why the committee made the recommendation

There was some very limited evidence for the effectiveness of behavioural couples therapy for
people with depression and who had problems in their relationship, but the committee agreed this
was a treatment that was available through the Improving Access to Psychological Therapy (IAPT)
services and should be included as an option in the guideline.

How the recommendation might affect practice How the recommendation might affect practice

The recommendation reflects current practice, but may reduce variation in practice across the
NHS.

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Preventing relapse Preventing relapse

Recommendations 1.8.1 to 1.8.12

Why the committee made the recommendations Why the committee made the recommendations

The committee highlighted a number of risk factors, based on their knowledge of the wider

literature and experience, which increase the likelihood of relapse. They agreed that people with a
higher risk of relapse should be considered for continuation of treatment, but recognised that not
all people would wish to take relapse prevention treatment. They also agreed those who wished to
continue on antidepressant medication should be warned about the possible long-term effects.

There was good evidence that SSRIs, SNRIs and TCAs, group CBT and mindfulness-based cognitive
therapy (MBCT) were effective for relapse prevention and were, on average, cost-effective
treatments for people at a high risk of relapse, with data for treatment periods up to 2 years. The

committee therefore recommended continuation antidepressant treatment or group CBT or

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